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Sample records for asia diabetes evaluation

  1. Delivery of integrated diabetes care using logistics and information technology--the Joint Asia Diabetes Evaluation (JADE) program.

    Science.gov (United States)

    Chan, Juliana C N; Ozaki, Risa; Luk, Andrea; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C; Wong, Patrick; Wong, Rebecca; Chung, Harriet; Chiu, Cherry; Wolthers, Troels; Tong, Peter C Y; Ko, Gary T C; So, Wing-Yee; Lyubomirsky, Greg

    2014-12-01

    Diabetes is a global epidemic, and many affected individuals are undiagnosed, untreated, or uncontrolled. The silent and multi-system nature of diabetes and its complications, with complex care protocols, are often associated with omission of periodic assessments, clinical inertia, poor treatment compliance, and care fragmentation. These barriers at the system, patient, and care-provider levels have resulted in poor control of risk factors and under-usage of potentially life-saving medications such as statins and renin-angiotensin system inhibitors. However, in the clinical trial setting, use of nurses and protocol with frequent contact and regular monitoring have resulted in marked differences in event rates compared to epidemiological data collected in the real-world setting. The phenotypic heterogeneity and cognitive-psychological-behavioral needs of people with diabetes call for regular risk stratification to personalize care. Quality improvement initiatives targeted at patient education, task delegation, case management, and self-care promotion had the largest effect size in improving cardio-metabolic risk factors. The Joint Asia Diabetes Evaluation (JADE) program is an innovative care prototype that advocates a change in clinic setting and workflow, coordinated by a doctor-nurse team and augmented by a web-based portal, which incorporates care protocols and a validated risk engine to provide decision support and regular feedback. By using logistics and information technology, supported by a network of health-care professionals to provide integrated, holistic, and evidence-based care, the JADE Program aims to establish a high-quality regional diabetes database to reflect the status of diabetes care in real-world practice, confirm efficacy data, and identify unmet needs. Through collaborative efforts, we shall evaluate the feasibility, acceptability, and cost-effectiveness of this "high tech, soft touch" model to make diabetes and chronic disease care more

  2. Gender, diabetes education, and psychosocial factors are associated with persistent poor glycemic control in patients with type 2 diabetes in the Joint Asia Diabetes Evaluation (JADE) program.

    Science.gov (United States)

    Yin, Junmei; Yeung, Roseanne; Luk, Andrea; Tutino, Greg; Zhang, Yuying; Kong, Alice; Chung, Harriet; Wong, Rebecca; Ozaki, Risa; Ma, Ronald; Tsang, Chiu-Chi; Tong, Peter; So, Wingyee; Chan, Juliana

    2016-01-01

    Factors associated with persistent poor glycemic control were explored in patients with type 2 diabetes under the Joint Asia Diabetes Evaluation (JADE) program. Chinese adults enrolled in JADE with HbA1c ≥8% at initial comprehensive assessment (CA1) and repeat assessment were analyzed. The improved group was defined as those with a ≥1% absolute reduction in HbA1c, and the unimproved group was those with education level, and was more likely to be insulin treated. Patients in the improved group received more diabetes education between CAs with improved self-care behaviors, whereas the unimproved group had worsening of health-related quality of life at CA2. Apart from female gender, long disease duration, low educational level, obesity, retinopathy, history of hypoglycemia, and insulin use, lack of education from diabetes nurses between CAs had the strongest association for persistent poor glycemic control. These results highlight the multidimensional nature of glycemic control, and the importance of diabetes education and optimizing diabetes care by considering psychosocial factors. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  3. From design to implementation - The Joint Asia Diabetes Evaluation (JADE program: A descriptive report of an electronic web-based diabetes management program

    Directory of Open Access Journals (Sweden)

    Lyubomirsky Greg

    2010-05-01

    Full Text Available Abstract Background The Joint Asia Diabetes Evaluation (JADE Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. Methods The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. Results The JADE electronic portal (e-portal: http://www.jade-adf.org is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. Conclusions The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes.

  4. From design to implementation--the Joint Asia Diabetes Evaluation (JADE) program: a descriptive report of an electronic web-based diabetes management program.

    Science.gov (United States)

    Ko, Gary T; So, Wing-Yee; Tong, Peter C; Le Coguiec, Francois; Kerr, Debborah; Lyubomirsky, Greg; Tamesis, Beaver; Wolthers, Troels; Nan, Jennifer; Chan, Juliana

    2010-05-13

    The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes.

  5. Gestational diabetes mellitus in South Asia: Epidemiology.

    Science.gov (United States)

    Jawad, Fatema; Ejaz, Kiran

    2016-09-01

    Gestational diabetes mellitus, is defined by the American Diabetes Association as "diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes". WHO has further classified the period of diagnosis as Hyperglycaemia in Pregnancy and Gestational Diabetes Mellitus. The former term is applicable in the early period of gestation and GDM is detected after 24 weeks. Irrespective of the guidelines followed, the presence of Diabetes Mellitus during pregnancy, has to be taken seriously as it is an important metabolic derangement and can prove to be harmful for the mother and dangerous for the foetus. The rising incidence of Type 2 Diabetes Mellitus in the world along with obesity, is a major contributing factor for GDM. The trend of this rise is more steep in the low and middle income countries thus proportionately increasing the risk for GDM. South Asia falls in this bracket and the responsible factors have to be identified and corrected. Management should begin from primordial prevention for which education is a key factor. Every woman should be taught the way to follow a healthy life style. Identification of the contributing factors and universal screening facilities for all pregnant women living in both rural and urban areas, should be given prime importance. On detecting Hyperglycaemia in Pregnancy or GDM, monitoring and health care facilities should be provided. This review provides some available figures of GDM in South Asia, the risk factors in this population and the steps for prevention.

  6. Association of persistent organic pollutants and non-persistent pesticides with diabetes and diabetes-related health outcomes in Asia: A systematic review.

    Science.gov (United States)

    Jaacks, Lindsay M; Staimez, Lisa R

    2015-03-01

    Over half of the people with diabetes in the world live in Asia. Emerging scientific evidence suggests that diabetes is associated with environmental pollutants, exposures that are also abundant in Asia. To systematically review the literature concerning the association of persistent organic pollutants (POPs) and non-persistent pesticides with diabetes and diabetes-related health outcomes in Asia. PubMed and Embase were searched to identify studies published up to November 2014. A secondary reference review of all extracted articles and the National Toxicology Program Workshop on the association of POPs with diabetes was also conducted. A total of 19 articles met the inclusion criteria and were evaluated in this review. To date, the evidence relating POPs and non-persistent pesticides with diabetes in Asian populations is equivocal. Positive associations were reported between serum concentrations of polychlorinated dibenzodioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs), and several organochlorine pesticides (DDT, DDE, oxychlordane, trans-nonachlor, hexachlorobenzene, hexachlorocyclohexane) with diabetes. PCDD/Fs were also associated with blood glucose and insulin resistance, but not beta-cell function. There were substantial limitations of the literature including: most studies were cross-sectional, few studies addressed selection bias and confounding, and most effect estimates had exceptionally wide confidence intervals. Few studies evaluated the effects of organophosphates. Well-conducted research is urgently needed on these pervasive exposures to inform policies to mitigate the diabetes epidemic in Asia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Advancing Evaluation Theory and Practice in South Asia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Advancing Evaluation Theory and Practice in South Asia: Community of Evaluators (CoE), Phase II. This Community of Evaluators (CoE) project will build on IDRC-funded work to promote and enhance the quality of the theory and practice of evaluation in South Asia. It will deepen and expand gains made by professional ...

  8. Advancing Evaluation Theory and Practice in South Asia : Building a ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Advancing Evaluation Theory and Practice in South Asia : Building a Community of Experts. This grant will allow the Association for Stimulating Know-how (ASK), an organization based in India with South Asian reach, to facilitate exchange between evaluation experts in South Asia through the creation and support of a ...

  9. Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium.

    Directory of Open Access Journals (Sweden)

    Paolo Boffetta

    Full Text Available The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia.A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 kg/m² as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76 for BMI lower than 15.0 kg/m² to 2.23 (95% CI 1.86, 2.67 for BMI higher than 34.9 kg/m². The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001, in cohorts from India and Bangladesh (p<0.001, in individuals with low education (p-value 0.02, and in smokers (p-value 0.03; no differences were observed by gender, urban residence, or alcohol drinking.This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk

  10. Making Evaluation Matter: Writings from South Asia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-27

    Apr 27, 2016 ... IDRC is a long-time supporter of South Asia's Community of Evaluators to advance evaluation practices in the region. With representation from Afghanistan, Bangladesh, Nepal, India, Pakistan, and Sri Lanka, the Community of Evaluators first came together in 2008. Since then, it has worked jointly on a ...

  11. Advancing Evaluation Theory and Practice in South Asia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This Community of Evaluators (CoE) project will build on IDRC-funded work to promote and enhance the quality of the theory and practice of evaluation in South Asia. It will deepen and expand gains made by professional evaluators from Afghanistan, Bangladesh, Nepal, India, Pakistan, and Sri Lanka. CoE members ...

  12. Making Evaluation Matter : Writings from South Asia | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Making Evaluation Matter : Writings from South Asia. Couverture du livre Making Evaluation Matter. Directeur(s) : Katherine Eve Hay et Shubh Kumar-Range. Maison(s) d'édition : SAGE, CRDI. 23 septembre 2014. ISBN : 9789351500278. 312 pages. e-ISBN : 9781552505830. Téléchargez le PDF · Téléchargez le cyberlivre.

  13. Monitoring and Evaluation for the Focus Cities Program in Asia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Monitoring and Evaluation for the Focus Cities Program in Asia. IDRC's Focus Cities Research Initiative (FCRI) is supporting research teams in nine cities around the world to promote awareness, policy options and best practices for reducing environmental impacts in poor urban and periurban areas. Jakarta, Indonesia, and ...

  14. Making Evaluation Matter: Writings from South Asia | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    27 avr. 2016 ... A recent achievement of the Community is the publication of the book,Making Evaluation Matter: Writings from South Asia. The book brings together a community of experts, and ... Offrir un choix aux agriculteurs pauvres: Harsha de Silva (Sri Lanka). Des téléphones mobiles relient les producteurs aux ...

  15. Making Evaluation Matter: Writings from South Asia | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    SAGE, IDRC. 23 septembre 2014. ISBN : 9789351500278. 312 pages. e-ISBN : 9781552505830. Téléchargez le PDF · Téléchargez le cyberlivre · Commandez le livre. This is a first-of-its-kind collection of writings by evaluation professionals working in South Asia. It analyses and documents the status of, and challenges for, ...

  16. Making Evaluation Matter: Writings from South Asia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2014-09-23

    Sep 23, 2014 ... The collection covers three critical dimensions of making evaluation matter in development processes and change in South Asia: context, methods, and use. ... IDRC has signed a Memorandum of Understanding (MoU) with the Government of India that enables Canada to continue supporting important ...

  17. Using Evaluation for CBNRM Capacity Development (Southeast Asia)

    International Development Research Centre (IDRC) Digital Library (Canada)

    Learning to use evaluation in CBNRM capacity development in Asia : ECD - CBNRM project brief 1. Download PDF. Reports ... Addressing inequality and environmental insecurity in the Middle East and North Africa (MENA) will require enhanced capacity to conduct social and gender analysis in environment and natural.

  18. Ouvrage Making Evaluation Matter: Writings from South Asia | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    27 avr. 2016 ... Récemment, la CoE a publié un livre intitulé Making Evaluation Matter: Writings from South Asia. Ce recueil d'écrits signés par des professionnels de l'évaluation travaillant en Asie du Sud est le tout premier du genre. Il analyse et documente le statut de l'évaluation du développement et les défis que les ...

  19. Urbanization and prevalence of type 2 diabetes in Southern Asia: A systematic analysis

    Science.gov (United States)

    Cheema, Arsalan; Adeloye, Davies; Sidhu, Simrita; Sridhar, Devi; Chan, Kit Yee

    2014-01-01

    Background Diabetes mellitus is one of the diseases considered to be the main constituents of the global non–communicable disease (NCD) pandemic. Despite the large impact that NCDs are predicted to have, particularly in developing countries, estimates of disease burden are sparse and inconsistent. This systematic review transparently estimates prevalence of type 2 diabetes mellitus in Southern Asia, its association with urbanization and provides insight into the policy challenges facing the region. Methods The databases Medline and PubMed were searched for population–based studies providing estimates of diabetes prevalence in the Southern Asia region. Studies using WHO diagnostic criteria of fasting plasma glucose (FPG) ≥7.0mmol/L and/or 2h–plasma glucose (2hPG) ≥11.1mmol/L were included. Data from eligible studies was extracted into bubble graphs, and trend lines were applied to UNPD figures to estimate age–specific prevalence in the regional population. Estimates specific to sex, area of residency, and diagnostic method were compared and trends analysed. Results A total of 151 age–specific prevalence estimates were extracted from 39 studies. Diabetes prevalence was estimated to be 7.47% for 2005 and 7.60% for 2010. Prevalence was strongly associated with increased age, male gender and urban residency (P Diabetes prevalence in Southern Asia is high and predicted to increase in the future as life expectancy rises and the region continues to urbanise. Countries in this region need to improve NCD surveillance and monitoring so policies can be informed with the best evidence. Programs for prevention need to be put in place, and health system capacity and access needs to be assessed and increased to deal with the predicted rise in NCD prevalence. PMID:24976963

  20. Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment

    Directory of Open Access Journals (Sweden)

    Jothydev Kesavadev

    2014-01-01

    Full Text Available Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

  1. Diabetic neuropathy and painful diabetic neuropathy: Cinderella complications in South East Asia.

    Science.gov (United States)

    Almuhannadi, Hamad; Ponirakis, Georgios; Khan, Adnan; Malik, Rayaz Ahmed

    2018-01-01

    The most common and debilitating microvascular complication of diabetes is diabetic peripheral neuropathy (DPN), affecting 50-90% of people with diabetes. The major manifestations of DPN are painful (pDPN) and painless diabetic peripheral neuropathy. Painful symptoms, occur in the feet and are worse at night and whilst they alert both the patient and physician, are often misdiagnosed and mismanaged. The devastating presentation of painless neuropathy with loss of sensation is foot ulceration and Charcot foot. The explosion of diabetes, especially in the South East Asian (SEA) region will result in an increasing prevalence of both painful and painless diabetic peripheral neuropathy. PubMed, EMBASE, Medline and Google Scholar databases were searched between 1990 and 2017. This highlights the widely varying prevalence of DPN and pDPN in the World Health Organization (WHO) defined SEA countries and the dearth of published studies, especially in pDPN. We believe this will provide new direction for future research on DPN in the SEA region.

  2. Diabetes epidemic in the Asia Pacific region: has hemoglobin A1C finally earned its place as a diagnostic tool?

    Directory of Open Access Journals (Sweden)

    Alexandra Bagley

    2014-02-01

    Full Text Available Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion. With China and India being the most populous nations on the globe, it is believed that over 150 million diabetes reside in the region with more than 95% being of type 2 diabetes mellitus (T2DM. Furthermore, other Pacific islands in the region have high rates of T2DM including Tonga, Fiji, French Polynesia, and Nauru. The latter has the highest prevalence of T2DM per population in the world. Over the past two decades, in Australia and New Zealand, the prevalence of T2DM has more than doubled, mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively. With the increasing prevalence of diabetes in the Asia Pacific region coupled with the limited number of resources, use of a reliable and effective mode of diagnosis for T2DM is warranted. Yet to date, only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease. The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.

  3. Field evaluation of reflective insulation in south east Asia

    Science.gov (United States)

    Teh, Khar San; Yarbrough, David W.; Lim, Chin Haw; Salleh, Elias

    2017-12-01

    The objective of this research was to obtain thermal performance data for reflective insulations in a South East Asia environment. Thermal resistance data (RSI, m2 ṡ K/W) for reflective insulations are well established from 1-D steady-state tests, but thermal data for reflective insulation in structures like those found in South East Asia are scarce. Data for reflective insulations in South East Asia will add to the worldwide database for this type of energy-conserving material. RSI were obtained from heat flux and temperature data of three identical structures in the same location. One unit did not have insulation above the ceiling, while the second and third units were insulated with reflective insulation with emittance less than 0.05. RSI for the uninsulated test unit varied from 0.37 to 0.40 m2 ṡ K/W. RSI for a single-sheet reflective insulation (woven foil) varied from 2.15 to 2.26 m2 ṡ K/W, while bubble-foil insulation varied from 2.69 to 3.09 m2 ṡ K/W. The range of RSI values resulted from differences in the spacing between the reflective insulation and the roof. In addition, the reflective insulation below the roof lowered attic temperatures by as much as 9.7° C. Reductions in ceiling heat flux of 80 to 90% relative to the uninsulated structure, due to the reflective insulation, were observed.

  4. Field evaluation of reflective insulation in south east Asia

    Directory of Open Access Journals (Sweden)

    Teh Khar San

    2017-12-01

    Full Text Available The objective of this research was to obtain thermal performance data for reflective insulations in a South East Asia environment. Thermal resistance data (RSI, m2 ⋅ K/W for reflective insulations are well established from 1-D steady-state tests, but thermal data for reflective insulation in structures like those found in South East Asia are scarce. Data for reflective insulations in South East Asia will add to the worldwide database for this type of energy-conserving material. RSI were obtained from heat flux and temperature data of three identical structures in the same location. One unit did not have insulation above the ceiling, while the second and third units were insulated with reflective insulation with emittance less than 0.05. RSI for the uninsulated test unit varied from 0.37 to 0.40 m2 ⋅ K/W. RSI for a single-sheet reflective insulation (woven foil varied from 2.15 to 2.26 m2 ⋅ K/W, while bubble-foil insulation varied from 2.69 to 3.09 m2 ⋅ K/W. The range of RSI values resulted from differences in the spacing between the reflective insulation and the roof. In addition, the reflective insulation below the roof lowered attic temperatures by as much as 9.7° C. Reductions in ceiling heat flux of 80 to 90% relative to the uninsulated structure, due to the reflective insulation, were observed.

  5. Diabetic Mario: Designing and Evaluating Mobile Games for Diabetes Education.

    Science.gov (United States)

    Baghaei, Nilufar; Nandigam, David; Casey, John; Direito, Artur; Maddison, Ralph

    2016-08-01

    Traditionally, diabetes education has relied on written materials, with limited resources available for children with diabetes. Mobile games can be effective and motivating tools for the promotion of children's health. In our earlier work, we proposed a novel approach for designing computer games aimed at educating children with diabetes. In this article, we apply our game design to a mobile Android game (Mario Brothers). We also introduce four heuristics that are specifically designed for evaluating the mobile game, by adapting traditional usability heuristics. Results of a pilot study (n = 12) to evaluate gameplay over 1-week showed that the children found the game engaging and improved their knowledge of healthy diet and lifestyle.

  6. Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis

    Science.gov (United States)

    2012-01-01

    Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies . PMID:22630043

  7. EVALUATION OF DRY EYES IN DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Anshu Sharma

    2017-12-01

    Full Text Available BACKGROUND According to the National Eye Institute, dry eye is a condition in which the eye does not produce tears properly. It can also involve tears not having the right consistency or evaporating too quickly. Tears are necessary to help maintain moisture on the surface of the eye and for clear vision. Diabetes is often associated with several significant ocular conditions such as retinopathy, refractive changes, cataracts, glaucoma and macular oedema. However, one of the most common ocular complications associated with diabetes is dry eye. The aim of the study is to study the prevalence of dry eyes in diabetes mellitus and to evaluate ocular and other risk factors relevant to diabetic dry eyes. MATERIALS AND METHODS A hospital-based cross-sectional clinical study of 100 diabetic patients who presented to the Department of Ophthalmology, Santosh Medical College and Hospital, Ghaziabad, between January 2016 to June 2017 was conducted. Detailed diabetic history was recorded. Assessment of anterior segment via slit-lamp biomicroscopy was done. The examinations for dry eyes included Schirmer's test, tear breakup time, fluorescein and rose Bengal staining. RESULTS Sixty two (62% diabetic patients had dry eye. The prevalence in type I was 3% and prevalence in type II was 59%. Dry eye prevalence was maximum in those above 40 years of age. Symptoms like reduced corneal sensation (44% and meibomitis (20% were major attributable risk factors. Ocular surface damage was predominantly superficial punctate keratitis. Retinopathy was not statistically associated with the prevalence of dry eyes. CONCLUSION Diabetes and dry eye appears to be a common association. Reduction in the modifiable risk factors of dry eye is essential to reduce its prevalence. No significant statistical correlation was found between retinopathy and dry eyes. However, examination for dry eyes should be an integral part of the assessment of diabetic eye disease.

  8. Simulating the impact of climate change on rice production in Asia and evaluating options for adaptation.

    NARCIS (Netherlands)

    Matthews, R.B.; Kropff, M.J.; Horie, T.; Bachelet, D.

    1997-01-01

    The likely effects of climate change caused by increasing atmospheric carbon dioxide levels on rice production in Asia were evaluated using two rice crop simulation models, ORYZA1 and SIMRIW, running under fixed-change' climate scenarios and scenarios predicted for a doubled-CO2 (2xCO2) atmosphere

  9. Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2015-01-01

    Full Text Available Since their introduction in clinical practice in the 1950′s, Sulfonylureas (SUs have remained the main-stay of pharmacotherapy in the management of type 2 diabetes. Despite their well-established benefits, their place in therapy is inappropriately being overshadowed by newer therapies. Many of the clinical issues associated with the use of SUs are agent-specific, and do not pertain to the class as such. Modern SUs (glimepiride, gliclazide MR are backed by a large body of evidence, experience, and most importantly, outcome data, which supports their role in managing patients with diabetes. Person-centred care, i.e., careful choice of SU, appropriate dosage, timing of administration, and adequate patient counseling, will ensure that deserving patients are not deprived of the advantages of this well-established class of anti-diabetic agents. Considering their efficacy, safety, pleiotropic benefits, and low cost of therapy, SUs should be considered as recommended therapy for the treatment of diabetes in South Asia. This initiative by SAFES aims to encourage rational, safe and smart prescription of SUs, and includes appropriate medication counseling.

  10. Using Evaluation for CBNRM Capacity Development (Southeast Asia)

    International Development Research Centre (IDRC) Digital Library (Canada)

    Rapports. Learning to evaluate capacity development for CBNRM : University Cluster Case Studies Planning Workshop, Beijing, September 21-23, 2006; workshop report. Rapports. Learning to evaluate capacity development for CBNRM : university cluster case studies planning workshop, Beijing, Sept. 21-23, 2006 ...

  11. Diabetic Nephropathy : Evaluation with Doppler Ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Sim, Jung Suk; Kim, Seung Hyup; Kang, Heung Sik; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-06-15

    To compare Doppler ultrasonography with laboratory tests in evaluation of diabetic nephropathy. Fifty-five patients (mean age = 60, M : F = 26 : 29) with diabetes mellitus underwent renal Doppler ultrasonography. Resistive indices were compared with degree of proteinuria, serum creatinine level, and creatinine clearance rate. Eighteen patients who showed no proteinuria or microscopic proteinuria had a mean resistive index (RI) of 0.72 (SD, 0.05), 16 patients with macroscopic proteinuria without nephrotic syndrome had a mean RI of 0.82 (SD, 0.13), and 21 patients with nephrotic syndrome had a mean RI of 0.90 (SD, 0.12). Renal RI correlated highly with serum creatinine level (r = 0.62) and creatinine clearance rate (r = -0.43). Renal Doppler ultrasonography provides a useful indication of renal function in diabetic nephropathy but cannot offer an advantage over conventional laboratory test

  12. Consumer evaluation of imported organic food products in emerging economies in Asia

    OpenAIRE

    Pedersen, Susanne; Aschemann-Witzel, Jessica; Thøgersen, John

    2017-01-01

    Consumer evaluation of imported organic food products in emerging economies in Asia Introduction Consumers in emerging economies such as Thailand and China have started to demand organic food products – mainly due to food safety reasons (Ortega, Wang, Wu, & Hong, 2015; Roitner-Schobesberger, Darnhofer, Somsook, & Vogl, 2008; C. L. Wang, Li, Barnes, & Ahn, 2012; O. Wang, De Steur, Gellynck, & Verbeke, 2015). However, since the domestic organic markets are still not well-establi...

  13. Evaluation of the Treatment of Diabetic Retinopathy A Research Project

    Science.gov (United States)

    Kupfer, Carl

    1973-01-01

    Evaluated is the treatment of diabetic retinopathy (blindness due to ruptured vessels of the retina as a side effect of diabetes), and described is a research project comparing two types of photocoagulation treatment. (DB)

  14. Patients' Evaluation of the Quality of Diabetes Care (PEQD)

    DEFF Research Database (Denmark)

    Pouwer, F; Snoek, Frank J

    2002-01-01

    OBJECTIVES: To develop a brief measure of patients' evaluation of the quality of diabetes care and to study predictors of consumers' rating of the quality of diabetes care. DESIGN: A prospective design. SUBJECTS: 176 adults with type 1 (39%) or type 2 (61%) diabetes. MAIN MEASURES: Demographic...... care. CONCLUSIONS: The PEQD comprises different aspects of quality of diabetes care and can be regarded as a suitable instrument for evaluating patients' judgements about the quality of their care....

  15. Evaluation of the Effect of Duration of Diabetes Mellitus on ...

    African Journals Online (AJOL)

    Background: and Objectives: Risk factors predisposing to foot ulceration in diabetic subjects are multiple. Long duration of diabetes mellitus is a major risk factor, likewise peripheral neuropathy (PN), which globally, is recognized as the commonest risk factor for foot disease in diabetic subjects. Objectives: To evaluate the ...

  16. The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia

    Directory of Open Access Journals (Sweden)

    Pradana Soewondo

    2010-11-01

    Full Text Available Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control in diabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, and quality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary and tertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examination reports including laboratory assessments were collected from medical records of patients. Blood samples of all patients were collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6 years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5% of the patients had type 2 diabetes. 67.9% had poor control of diabetes (A1c:8.1 ± 2.0%. 47.2% had FPG>130 mg/dL (161.6±14.6 mg/dL. Dyslipidemia was reported in 60%  (834/1390 and 74% (617/834 of those received lipid lowering treatment. Neuropathy was most common  complication (63.5%; other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications 16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs (± insulin, 37.7% were on insulin (±OADs. Majority used biguanides followed by sulfonylureas. Human insulin was used by 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell in positive territoryConclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion of patients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management should be adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide proper healthcare and its facilities in

  17. Inpatient treatment of diabetic patients in Asia: evidence from India, China, Thailand and Malaysia.

    Science.gov (United States)

    Goldhaber-Fiebert, J D; Li, H; Ratanawijitrasin, S; Vidyasagar, S; Wang, X Y; Aljunid, S; Shah, N; Wang, Z; Hirunrassamee, S; Bairy, K L; Wang, J; Saperi, S; Nur, A M; Eggleston, K

    2010-01-01

    The prevalence of Type 2 diabetes mellitus (DM) has grown rapidly, but little is known about the drivers of inpatient spending in low- and middle-income countries. This study aims to compare the clinical presentation and expenditure on hospital admission for inpatients with a primary diagnosis of Type 2 DM in India, China, Thailand and Malaysia. We analysed data on adult, Type 2 DM patients admitted between 2005 and 2008 to five tertiary hospitals in the four countries, reporting expenditures relative to income per capita in 2007. Hospital admission spending for diabetic inpatients with no complications ranged from 11 to 75% of per-capita income. Spending for patients with complications ranged from 6% to over 300% more than spending for patients without complications treated at the same hospital. Glycated haemoglobin was significantly higher for the uninsured patients, compared with insured patients, in India (8.6 vs. 8.1%), Hangzhou, China (9.0 vs. 8.1%), and Shandong, China (10.9 vs. 9.9%). When the hospital admission expenditures of the insured and uninsured patients were statistically different in India and China, the uninsured always spent less than the insured patients. With the rising prevalence of DM, households and health systems in these countries will face greater economic burdens. The returns to investment in preventing diabetic complications appear substantial. Countries with large out-of-pocket financing burdens such as India and China are associated with the widest gaps in resource use between insured and uninsured patients. This probably reflects both overuse by the insured and underuse by the uninsured.

  18. [Evaluation of corneal endothelium morphology in diabetic patients].

    Science.gov (United States)

    Wesołek-Czernik, Agata; Bartela, Joanna; Zamojska, Ewa; Omulecki, Wojciech

    2007-01-01

    To evaluate the influence of diabetes mellitus and type of hipoglicemic therapy on corneal endothelium cell morphology. In 68 diabetic patients' eyes with non proliferative diabetic retinopathy (29 males and 39 females), corneal endothelium was studied. Patients age was between 50 and 82 years (mean 63.28). As age-matched control group we analyzed 58 eyes of non diabetic patients. Corneal endothelium density, percentage of corneal endothelium hexagonal cells, average size of corneal endothelium cells and corneal thickness were imaged by non-contact specular microscope TOPCON SP-2000P. The mean corneal endothelium cell density was: 2467 cells/mm2 in diabetic patients, and 2573 cells/mm2 in control group. The mean percentage of corneal endothelium hexagonal cells was: 55.3% in diabetic patients treated with insulin and 52.9% in diabetic patients treated with oral antidiabetic drugs, and 54.4% in the control group. The mean size of corneal endothelium cells was: 414.6 microm2 in diabetic patients, and 395.9 microm2 in the control group. The mean corneal thickness was: 0.556 mm in diabetic patients and 0.545 mm in the control group. Corneal endothelium was thicker in diabetic patients than in non diabetic patients. The duration of diabetes mellitus had no influence on corneal endothelium cell morphology. Diabetic patients treated with oral antidiabetic drugs had larger percentage of hexagonal cells than those treated with insulin.

  19. Development and evaluation of an operational SDS forecasting system for East Asia: CUACE/DUST

    Science.gov (United States)

    Zhou, C. H.; Gong, S. L.; Zhang, X. Y.; Wang, Y. Q.; Niu, T.; Liu, H. L.; Zhao, T. L.; Yang, Y. Q.; Hou, Q.

    2007-06-01

    CUACE/Dust, an operational sand and dust storm (SDS) forecasting system for East Asia, was developed at CMA (China Meteorological Administration) by integrating a meso-scale dust aerosol model with a 3DVar data assimilation system that uses both surface network observation data and dust intensity data retrieved from the Chinese Geostationary Satellite FY-2C. For spring 2006, CUACE/Dust successfully forecasted most of the 31 SDS episodes in East Asia. A detailed comparison of the modeling predictions for the 8-12 March episode with surface network observations and lidar measurements revealed a robust forecasting ability of the system. The time series of the forecasted dust concentrations for a number of representative stations for the whole spring 2006 were also evaluated against surface PM10 monitoring data, showing a very good agreement in terms of the SDS timing and magnitudes near source regions where dust aerosols dominate. For the entire domain forecasts in spring 2006 (1 March-31 May), a TS (thread score) system evaluated the performance of the system against all available observations and rendered an averaged TS value of 0.31 for 24 h forecasts, 0.23 for 48 h and 0.21 for 72 h forecasts.

  20. Evaluation and Prevention of Diabetic Neuropathy

    Directory of Open Access Journals (Sweden)

    Pajouhi M

    2007-07-01

    Full Text Available Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.

  1. A multi-model evaluation of aerosols over South Asia: common problems and possible causes

    Science.gov (United States)

    Pan, X.; Chin, M.; Gautam, R.; Bian, H.; Kim, D.; Colarco, P. R.; Diehl, T. L.; Takemura, T.; Pozzoli, L.; Tsigaridis, K.; Bauer, S.; Bellouin, N.

    2015-05-01

    Atmospheric pollution over South Asia attracts special attention due to its effects on regional climate, water cycle and human health. These effects are potentially growing owing to rising trends of anthropogenic aerosol emissions. In this study, the spatio-temporal aerosol distributions over South Asia from seven global aerosol models are evaluated against aerosol retrievals from NASA satellite sensors and ground-based measurements for the period of 2000-2007. Overall, substantial underestimations of aerosol loading over South Asia are found systematically in most model simulations. Averaged over the entire South Asia, the annual mean aerosol optical depth (AOD) is underestimated by a range 15 to 44% across models compared to MISR (Multi-angle Imaging SpectroRadiometer), which is the lowest bound among various satellite AOD retrievals (from MISR, SeaWiFS (Sea-Viewing Wide Field-of-View Sensor), MODIS (Moderate Resolution Imaging Spectroradiometer) Aqua and Terra). In particular during the post-monsoon and wintertime periods (i.e., October-January), when agricultural waste burning and anthropogenic emissions dominate, models fail to capture AOD and aerosol absorption optical depth (AAOD) over the Indo-Gangetic Plain (IGP) compared to ground-based Aerosol Robotic Network (AERONET) sunphotometer measurements. The underestimations of aerosol loading in models generally occur in the lower troposphere (below 2 km) based on the comparisons of aerosol extinction profiles calculated by the models with those from Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) data. Furthermore, surface concentrations of all aerosol components (sulfate, nitrate, organic aerosol (OA) and black carbon (BC)) from the models are found much lower than in situ measurements in winter. Several possible causes for these common problems of underestimating aerosols in models during the post-monsoon and wintertime periods are identified: the aerosol hygroscopic growth and formation of

  2. Diabetes insipidus in pregnancy: etiology, evaluation, and management.

    Science.gov (United States)

    Ananthakrishnan, Sonia

    2009-01-01

    To review the approach to a patient with diabetes insipidus during pregnancy. This review examines the normal physiology of water homeostasis, the related changes that occur during pregnancy, and the pathophysiology of diabetes insipidus in pregnancy. Associated complications, evaluation, and management are discussed. Diabetes insipidus can complicate up to 1 in 30,000 pregnancies. Diabetes insipidus during pregnancy has a variety of causes, some that predate the pregnancy and others that begin during gestation. Polyuria and polydipsia can occur or be exacerbated in women with overt or subclinical central or nephrogenic diabetes insipidus. These women have either decreased central secretory reserve or impaired renal responsiveness to vasopressin. In addition, women can experience diabetes insipidus de novo in pregnancy through the actions of placental vasopressinase, which causes accelerated degradation of vasopressin. This form of diabetes insipidus may be associated with increased complications of pregnancy, including preeclampsia. Management of central diabetes insipidus and transient diabetes insipidus of pregnancy can be achieved with 1-deamino-8-D-arginine vasopressin (desmopressin acetate) (DDAVP), a vasopressin analogue. Nephrogenic diabetes insipidus is typically resistant to both DDAVP and vasopressin and underlying causes should be addressed. Increased awareness of diabetes insipidus in pregnancy may lead to early diagnosis and appropriate treatment that will reduce the risks of maternal and fetal morbidity. Overall, growing experience with DDAVP has shown that it is a safe and effective treatment for diabetes insipidus caused by a variety of factors.

  3. An evaluation of postprandial glucose excursions in type 2 diabetic ...

    African Journals Online (AJOL)

    An evaluation of postprandial glucose excursions in type 2 diabetic mellitus subjects on Monotard® HM (ge) versus Humulin N® or Humulin L® insulin, each in combination with metformin. ... The subjects had a mean duration of diabetes of 11.4 ± 6.6 years, with 71% (n = 22) having a positive family history. The study cohort ...

  4. Evaluation of the DNA barcodes in Dendrobium (Orchidaceae from mainland Asia.

    Directory of Open Access Journals (Sweden)

    Songzhi Xu

    Full Text Available DNA barcoding has been proposed to be one of the most promising tools for accurate and rapid identification of taxa. However, few publications have evaluated the efficiency of DNA barcoding for the large genera of flowering plants. Dendrobium, one of the largest genera of flowering plants, contains many species that are important in horticulture, medicine and biodiversity conservation. Besides, Dendrobium is a notoriously difficult group to identify. DNA barcoding was expected to be a supplementary means for species identification, conservation and future studies in Dendrobium. We assessed the power of 11 candidate barcodes on the basis of 1,698 accessions of 184 Dendrobium species obtained primarily from mainland Asia. Our results indicated that five single barcodes, i.e., ITS, ITS2, matK, rbcL and trnH-psbA, can be easily amplified and sequenced with the currently established primers. Four barcodes, ITS, ITS2, ITS+matK, and ITS2+matK, have distinct barcoding gaps. ITS+matK was the optimal barcode based on all evaluation methods. Furthermore, the efficiency of ITS+matK was verified in four other large genera including Ficus, Lysimachia, Paphiopedilum, and Pedicularis in this study. Therefore, we tentatively recommend the combination of ITS+matK as a core DNA barcode for large flowering plant genera.

  5. Evaluation of the DNA barcodes in Dendrobium (Orchidaceae) from mainland Asia.

    Science.gov (United States)

    Xu, Songzhi; Li, Dezhu; Li, Jianwu; Xiang, Xiaoguo; Jin, Weitao; Huang, Weichang; Jin, Xiaohua; Huang, Luqi

    2015-01-01

    DNA barcoding has been proposed to be one of the most promising tools for accurate and rapid identification of taxa. However, few publications have evaluated the efficiency of DNA barcoding for the large genera of flowering plants. Dendrobium, one of the largest genera of flowering plants, contains many species that are important in horticulture, medicine and biodiversity conservation. Besides, Dendrobium is a notoriously difficult group to identify. DNA barcoding was expected to be a supplementary means for species identification, conservation and future studies in Dendrobium. We assessed the power of 11 candidate barcodes on the basis of 1,698 accessions of 184 Dendrobium species obtained primarily from mainland Asia. Our results indicated that five single barcodes, i.e., ITS, ITS2, matK, rbcL and trnH-psbA, can be easily amplified and sequenced with the currently established primers. Four barcodes, ITS, ITS2, ITS+matK, and ITS2+matK, have distinct barcoding gaps. ITS+matK was the optimal barcode based on all evaluation methods. Furthermore, the efficiency of ITS+matK was verified in four other large genera including Ficus, Lysimachia, Paphiopedilum, and Pedicularis in this study. Therefore, we tentatively recommend the combination of ITS+matK as a core DNA barcode for large flowering plant genera.

  6. [Evaluation of nopal capsules in diabetes mellitus].

    Science.gov (United States)

    Frati Munari, A C; Vera Lastra, O; Ariza Andraca, C R

    1992-01-01

    To find out if commercial capsules with dried nopal (prickle-pear cactus, Opuntia ficus indica may have a role in the management of diabetes mellitus, three experiments were performed: 30 capsules where given in fasting condition to 10 diabetic subjects and serum glucose was measured through out 3 hours; a control test was performed with 30 placebo capsules. OGTT with previous intake of 30 nopal or placebo capsules was performed in ten healthy individuals. In a crossover and single blinded study 14 diabetic patients withdrew the oral hypoglycemic treatment and received 10 nopal or placebo capsules t.i.d. during one week; serum glucose, cholesterol and tryglycerides levels were measured before and after each one-week period. Five healthy subjects were also studied in the same fashion. Opuntia capsules did not show acute hypoglycemic effect and did not influence OGTT. In diabetic patients serum glucose, cholesterol and tryglycerides levels did not change with Opuntia, but they increased with placebo (P nopal, while cholesterol and triglycerides decreased (P < 0.01 vs. placebo). The intake of 30 Opuntia capsules daily in patients with diabetes mellitus had a discrete beneficial effect on glucose and cholesterol. However this dose is unpractical and at present it is not recommended in the management of diabetes mellitus.

  7. PolEASIA Project: Pollution in Eastern Asia - towards better Air Quality Prevision and Impacts' Evaluation

    Science.gov (United States)

    Dufour, Gaëlle; Albergel, Armand; Balkanski, Yves; Beekmann, Matthias; Cai, Zhaonan; Fortems-Cheiney, Audrey; Cuesta, Juan; Derognat, Claude; Eremenko, Maxim; Foret, Gilles; Hauglustaine, Didier; Lachatre, Matthieu; Laurent, Benoit; Liu, Yi; Meng, Fan; Siour, Guillaume; Tao, Shu; Velay-Lasry, Fanny; Zhang, Qijie; Zhang, Yuli

    2017-04-01

    The rapid economic development and urbanization of China during the last decades resulted in rising pollutant emissions leading to amongst the largest pollutant concentrations in the world for the major pollutants (ozone, PM2.5, and PM10). Robust monitoring and forecasting systems associated with downstream services providing comprehensive risk indicators are highly needed to establish efficient pollution mitigation strategies. In addition, a precise evaluation of the present and future impacts of Chinese pollutant emissions is of importance to quantify: first, the consequences of pollutants export on atmospheric composition and air quality all over the globe; second, the additional radiative forcing induced by the emitted and produced short-lived climate forcers (ozone and aerosols); third, the long-term health consequences of pollution exposure. To achieve this, a detailed understanding of East Asian pollution is necessary. The French PolEASIA project aims at addressing these different issues by providing a better quantification of major pollutants sources and distributions as well as of their recent and future evolution. The main objectives, methodologies and tools of this starting 4-year project will be presented. An ambitious synergistic and multi-scale approach coupling innovative satellite observations, in situ measurements and chemical transport model simulations will be developed to characterize the spatial distribution, the interannual to daily variability and the trends of the major pollutants (ozone and aerosols) and their sources over East Asia, and to quantify the role of the different processes (emissions, transport, chemical transformation) driving the observed pollutant distributions. A particular attention will be paid to assess the natural and anthropogenic contributions to East Asian pollution. Progress made with the understanding of pollutant sources, especially in terms of modeling of pollution over East Asia and advanced numerical approaches

  8. Evaluating dietary quality in diabetes by the Healthy Eating Index.

    Science.gov (United States)

    Direktör, Şevket; Özer, Emel

    2013-01-01

    Diabetes and diabetes-induced complications is a rising health concern in Northern Cyprus. Of the adult population in Northern Cyprus, 12.2% has diabetes and 90% of all individuals suffering from cardiovascular disease are people with diabetes. The aim of this study was to evaluate nutritional habits of people with diabetes in Northern Cyprus in order to make the necessary recommendations to improve their eating habits to prevent diabetes-induced complications. We used the Healthy Eating Index (HEI) to evaluate dietary quality of people with diabetes in Northern Cyprus based on their 24-hour food intake. A total of 200 participants with diabetes were selected randomly from the out-patient clinic of Dr. Burhan Nalbantoğlu central hospital in Nicosia. Individuals were asked to complete a questionnaire to determine their 24-hour food intake and frequency of intake of various food substances. The mean HEI score for the subjects with diabetes was 58.8. The HEI component scores for saturated fat, vegetables, dairy products and meat consumption were less than 5, whereas average scores for fat, cholesterol, fruits, grains, and sodium consumption were more than 5. The meat component of the HEI had the lowest mean score (3.3). There was statistical significance between male and female subjects regarding the HEI scores for meat and nutrient variety intake. In conclusion, the results of the present study suggest that subjects with diabetes in Northern Cyprus should improve their diet by decreasing their intake of saturated fat and by increasing their intake of vegetables, meat and milk.

  9. Evaluation of Jamaican Knowledge of Diabetes and Health Beliefs

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    Melody L. Hartzler

    2014-01-01

    Full Text Available Background & Aims: The International Diabetes Federation (IDF estimated that over 382 million people worldwide were affected by diabetes in 2013. The Caribbean region consistently is above the global average in regard to diabetes prevalence. Specifically, in Jamaica, researchers have found that the management of diabetes is not consistent with international guidelines, and in Caribbean culture, there are additional health beliefs that may need to be addressed. The purpose of this study is to (1 evaluate patient diabetes-related knowledge and health beliefs and (2 determine the association between diabetes-related knowledge and health beliefs in rural Jamaica. Methods: Rural Jamaican patients with diabetes (N=48, mean age = 55.16±15.08 were asked to complete questionnaires for cross-sectional examination of knowledge and health beliefs during a medical mission trip to the parish of St. Elizabeth in Jamaica. Participants were asked to verbally complete the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD, 10 items and Health Belief Model-11 (HBM-11, 11 items, as well as a demographic instrument. Analyses were performed in SPSS v. 20.0. Descriptive statistics were performed for all items. Spearman or Pearson correlations, as appropriate, were utilized to assess associations. Differences in HBM subscales by demographic characteristics were assessed using paired t-tests. Results: Participants had poor knowledge of diabetes, particularly regarding signs and symptoms of hyper/hypoglycemia, importance of foot and eye exams, fasting blood glucose levels, and long-term diabetes complications. Knowledge deficits were associated with educational attainment, as many participants had only completed primary school. Most participants indicated they were ready to take action regarding their health, but they perceived there were significant barriers to doing so. Also, older adults were more likely to believe that they could control their diabetes

  10. 78 FR 47326 - Proposed Collection; 60-Day Comment Request: Community Evaluation of the National Diabetes...

    Science.gov (United States)

    2013-08-05

    ... of proven strategies to prevent or delay the onset of diabetes and its complications. The NDEP... effective strategies for preventing type 2 diabetes and complications associated with diabetes; (2) Increase... Evaluation of the National Diabetes Education Program's Diabetes HealthSense Web site Summary: In compliance...

  11. Evaluation of MODIS Deep Blue Aerosol Algorithm in Desert Region of East Asia: Ground Validation and Intercomparison

    Science.gov (United States)

    Tao, Minghui; Chen, Liangfu; Wang, Zifeng; Wang, Jun; Che, Huizheng; Xu, Xiaoguang; Wang, Wencai; Tao, Jinhua; Zhu, Hao; Hou, Can

    2017-10-01

    The abundant dust particles from widespread deserts in East Asia play a significant role in regional climate and air quality. In this study, we provide a comprehensive evaluation of the widely used Moderate Resolution Imaging Spectroradiometer (MODIS) Deep Blue (DB) aerosol retrievals in desert regions of East Asia using ground-based observations over eight sites of the China Aerosol Remote Sensing Network (CARSNET). Different from their well-characterized performance in urban and cropland areas around the globe, DB aerosol optical depth (AOD) retrievals exhibit underestimation across the deserts in East Asia. We found that 38%-96% of satellite values fall out of an expected-error envelope of ±(0.05 + 20%AODCARSNET), with the worst performance in Taklimakan Desert. In particular, DB retrievals erroneously give a nearly constant low values of 0.05 in Taklimakan Desert when AOD is below 0.5, which does not match with variation of moderate dust plumes. Comparison with Multi-angle Imaging SpectroRadiometer AOD shows that a similar underestimation is prevalent over the extensive deserts. Inversion of sky light measurements show that single scattering albedos of the yellow dust in East Asia are mostly below 0.9 at 440 nm, much lower than the "whiter" and "redder" dust models applied in the DB algorithm. On the other hand, overestimation of surface reflectance dominantly contributes to the significant low constant AOD values in MODIS DB retrievals in Taklimakan Desert. These large biases, however, can be substantially reduced by considering unique characteristics of aerosols and surface over the arid regions in East Asia.

  12. Evaluation of long range transport of fossil fuel originated organic aerosol at a background site in Northeast Asia

    Science.gov (United States)

    Hwang, Eun Jin; Lee, Ji Yi; Park, Jin Soo; Lee, Seok Jo; Kim, Hyun Jae; Jeon, Ha Eun; Sung, Min Young

    2013-04-01

    Northeast Asia is heavy air pollution region due to usage of large amounts of fossil fuel. In addition, meteorological conditions represented as prevailing westerlies in Northeast Asia region causes long range transport of anthropogenic pollutants emitted from China to Korea and Japan and even the United States across the Pacific Ocean (Bey et al., 2001). The Baengnyeong Island of Korea is located at the northwestern part of the Korean peninsula and close by North Korea and China, thus this site is regarded as an ideal place for background air measurements in Northeast Asia. Also, it has low local anthropogenic emissions and is frequently influenced by various air masses from China and North Korea in the Island. In this study, we performed intensive sampling during summer and winter in the Baengnyeong Island and analyzed various organic compounds including fossil fuel originated organic markers such as hopanes and PAHs using thermal desorption two dimensional gas chromatography with time of flight mass spectrometry (TD-GC×GC-TOFMS). We also analyzed ~20 urban aerosol samples collected at Seoul, a representative urban site in Northeast Asia region to compare organic compounds distributions of aerosol samples at the Baengnyeong Island. By applying air mass back trajectory analysis and comparing organic compounds distributions in aerosol samples of the Baengnyeong Island and Seoul, the impact of long-range transport of fossil fuel originated organic pollutants at a background site in Northeast Asia were evaluated. (References) Bey, I., Jacob, D.J., Logan, J.A., Yantosca, R.M., 2001. Asian chemical outflow to the Pacific in spring: origins, pathways, and budgets. Journal of Geophysical Research-Atmosphere 106, 23097-23113.

  13. Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

    Science.gov (United States)

    Lai, Stefano; Cagetti, Maria Grazia; Cocco, Fabio; Cossellu, Dina; Meloni, Gianfranco; Campus, Guglielmo; Lingström, Peter

    2017-01-01

    To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status. Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4-14 years) were enrolled. The diabetic children were divided: a) 20 children in good metabolic control (Hb1ac≤7.5) and b) 48 children in bad metabolic control (Hb1ac>7.5). Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse. Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively) and in subjects in bad metabolic control (p = 0.03 and pnon-diabetic children (p = 0.04). No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (pdifference for the main cariogenic bacteria was found between diabetic and non-diabetic subjects (pdifferences between diabetic and non-diabetic subjects and between diabetic subjects in good and bad metabolic control (pDiabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

  14. Comparative effectiveness of dipeptidyl peptidase-4 (DPP-4 inhibitors and human glucagon-like peptide-1 (GLP-1 analogue as add-on therapies to sulphonylurea among diabetes patients in the Asia-Pacific region: a systematic review.

    Directory of Open Access Journals (Sweden)

    Martin C S Wong

    Full Text Available The prevalence of diabetes mellitus is rising globally, and it induces a substantial public health burden to the healthcare systems. Its optimal control is one of the most significant challenges faced by physicians and policy-makers. Whereas some of the established oral hypoglycaemic drug classes like biguanide, sulphonylureas, thiazolidinediones have been extensively used, the newer agents like dipeptidyl peptidase-4 (DPP-4 inhibitors and the human glucagon-like peptide-1 (GLP-1 analogues have recently emerged as suitable options due to their similar efficacy and favorable side effect profiles. These agents are widely recognized alternatives to the traditional oral hypoglycaemic agents or insulin, especially in conditions where they are contraindicated or unacceptable to patients. Many studies which evaluated their clinical effects, either alone or as add-on agents, were conducted in Western countries. There exist few reviews on their effectiveness in the Asia-Pacific region. The purpose of this systematic review is to address the comparative effectiveness of these new classes of medications as add-on therapies to sulphonylurea drugs among diabetic patients in the Asia-Pacific countries. We conducted a thorough literature search of the MEDLINE and EMBASE from the inception of these databases to August 2013, supplemented by an additional manual search using reference lists from research studies, meta-analyses and review articles as retrieved by the electronic databases. A total of nine randomized controlled trials were identified and described in this article. It was found that DPP-4 inhibitors and GLP-1 analogues were in general effective as add-on therapies to existing sulphonylurea therapies, achieving HbA1c reductions by a magnitude of 0.59-0.90% and 0.77-1.62%, respectively. Few adverse events including hypoglycaemic attacks were reported. Therefore, these two new drug classes represent novel therapies with great potential to be major

  15. The political and scientific challenges in evaluating compulsory drug treatment centers in Southeast Asia.

    Science.gov (United States)

    Vuong, Thu; Nguyen, Nhu; Le, Giang; Shanahan, Marian; Ali, Robert; Ritter, Alison

    2017-01-11

    In Vietnam, like many countries in Southeast Asia, the commonly used approach of center-based compulsory drug treatment (CCT) has been criticized on human rights ground. Meanwhile, community-based voluntary methadone maintenance treatment (MMT) has been implemented for nearly a decade with promising results. Reform-minded leaders have been seeking empirical evidence of the costs and effectiveness associated with these two main treatment modalities. Conducting evaluations of these treatments, especially where randomization is not ethical, presents challenges. The aim of this paper is to discuss political challenges and methodological issues when conducting cost-effectiveness studies within the context of a non-democratic Southeast Asian country. A retrospective analysis of the political and scientific challenges that were experienced in the study design, sample size determination, government approval and ethics approvals, participant recruitment, data collection, and determination of sources, and quantification of cost and effectiveness data was undertaken. As a consequence of the non-randomized design, analysis of patient characteristics for both treatment types was undertaken to identify the magnitude of baseline group differences. Concordance between self-reported heroin use and urine drug testing was undertaken to determine the reliability of self-report data in a politically challenging environment. We demonstrate that conducting research around compulsory treatment in a non-democratic society is feasible, yet it is politically challenging and requires navigation between science and politics. We also demonstrate that engagement with the government decision makers in the research conception, implementation, and dissemination of the results increases the likelihood of research evidence being considered for change in a contentious drug policy area. Local empirical evidence on the comparative cost-effectiveness of CCT and MMT in a Southeast Asian setting is

  16. Evaluation of Plasma Lipoprotein (A Levels in Diabetic and Non Diabetic Indiviuals

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    BA Jalai

    2005-01-01

    Full Text Available Introduction: Lipoprotein (a is a particle rich in cholesterol in human plasma and it is known as an independent risk factor for coronary artery disease. In addition to genetic background, other factors such as diabetes affect the plasma concentration of this lipoprotein as a risk factor. The aim of this study was evaluation and comparison of plasma concentration of Lp(a in type II diabetics and non diabetic individuals. Material and Methods: The study population included 180 diabetic patients who had referred to the Diabetic Research center of Yazd and 180 non diabetic individuals who were matched according to age and sex with the patient group. Blood samples were collected from the study groups in fasting condition. Glycated hemoglobin, glucose, lipids and lipoproteins were measured by routine laboratory methods and Lp(a assay was carried out by electro immunodiffusion. Results were analyzed with the use of SPSS program. Statistical tests included variance analysis, t-test for comparing lipids and lipoproteins, U-test for comparing Lp(a in the two groups and Pearson Correlation for determining of the variables with Lp(a. Results: Mean plasma concentratin of Lp(a in diabetic patients (Mean + SD 41.98+ 34.63 mg/dl was significantly higher than that of the control group (26.6 + 20.2 mg/dl (P<0.001. Mean concentration of cholesterol, triglyceride and LDL cholesterol in the patient group was higher but mean HDL cholesterol in control group was higher than patient group. However, no significant correlation was found between Lp(a and other variables in the patient and control groups. Conclusion: Plasma concentration of Lp(a in Diabetes Mellitus is increased independently. In diabetic patients, the risk of coronary artery disease may increase with increase in Lp(a.

  17. Evaluation of Experiential Outdoor Research Locations in Asia for a K-12 school in Hong Kong

    Science.gov (United States)

    Ibarra, D. L.; Joyce, S.

    2016-12-01

    A team of faculty and administrators from The Independent Schools Foundation Academy spend the 2015 - 2016 academic year identifying possible locations in Asia for a year-round outdoor education center. ISF Academy currently has over 1500 students its K-12 bilingual school in Hong Kong, China. The outdoor education center is an extension of the built campus in Pokfulam and will provide students opportunities to live in a natural setting, participate in outdoor educational activities and study in an environment significantly different than a classroom. Currently ISF Academy students in grades 4 - 12 are off campus twice during the academic year in an experiential learning environment. These current programs include camping, hiking, kayaking, other adventurous activities and service learning opportunities. The purpose of the dedicated site is to have a "home base" for ISF Academy and the experiential learning programs. This past year we looked specifically at programs and locations that could also be used by students for ecology and earth systems based research in the senior school (grades 9 - 12). We have looked at sites in Hong Kong, Indonesia, Malaysia and Taiwan. The ideal site will have marine, terrestrial and mangrove ecosystems and allow students to set up long-term research sites in any of these ecosystems. Creating opportunities for authentic research that allows students spend an extended time in a research setting will help them to gain both skills and independence needed in the future at the tertiary level. The evaluation of these sites included identifying potential research partners, site preparation, logistics in and out of the locations, and the heath/safety management of students living and working in a remote location. In parallel to the site evaluations, the curriculum is being developed for the students that is age and skill appropriate using the frame work of the existing guided discovery curriculum in the primary school, and the MYP and DP

  18. Computer vision algorithm for diabetic foot injury identification and evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Castaneda M, C. L.; Solis S, L. O.; Martinez B, M. R.; Ortiz R, J. M.; Garza V, I.; Martinez F, M.; Castaneda M, R.; Vega C, H. R., E-mail: lsolis@uaz.edu.mx [Universidad Autonoma de Zacatecas, 98000 Zacatecas, Zac. (Mexico)

    2016-10-15

    Diabetic foot is one of the most devastating consequences related to diabetes. It is relevant because of its incidence and the elevated percentage of amputations and deaths that the disease implies. Given the fact that the existing tests and laboratories designed to diagnose it are limited and expensive, the most common evaluation is still based on signs and symptoms. This means that the specialist completes a questionnaire based solely on observation and an invasive wound measurement. Using the questionnaire, the physician issues a diagnosis. In the sense, the diagnosis relies only on the criteria and the specialists experience. For some variables such as the lesions area or their location, this dependency is not acceptable. Currently bio-engineering has played a key role on the diagnose of different chronic degenerative diseases. A timely diagnose has proven to be the best tool against diabetic foot. The diabetics foot clinical evaluation, increases the possibility to identify risks and further complications. The main goal of this paper is to present the development of an algorithm based on digital image processing techniques, which enables to optimize the results on the diabetics foot lesion evaluation. Using advanced techniques for object segmentation and adjusting the sensibility parameter, allows the correlation between the algorithms identified wounds and those observed by the physician. Using the developed algorithm it is possible to identify and assess the wounds, their size, and location, in a non-invasive way. (Author)

  19. Anthropometric evaluation in diabetic patients with ischemic stroke

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    Holanda Maurus Marques de Almeida

    2006-01-01

    Full Text Available Strokes are one of the most common causes of mortality and long term severe disability. Risk factors for stroke include: age, gender, diabetes mellitus (DM, hypertension, and many others. OBJECTIVE: To evaluate obesity and hypertension in patients affected by acute ischemic stroke. METHOD: We compared the anthropometric variables between type II diabetic patients and non-diabetic patients. We evaluated a total of 60 patients, divided into two groups: 34 non-diabetic patients and a group of 26 type II diabetic subjects. RESULTS: The predominance of obesity, as well as hypertension, was very high among the studied groups, presenting no differences among the waist-hip ratio (WHR values of the study group compared to the ones of the control group. CONCLUSION: The predominance of obesity was very high among the studied groups and there was prevalence the android type obesity. There was no significative difference in the anthropometric evaluation by the measurement of WHR and the waist in the groups.

  20. Comparison of clinical outcomes in diabetic and non-diabetic burns patients in a national burns referral centre in southeast Asia: A 3-year retrospective review.

    Science.gov (United States)

    Low, Zhao-Kai; Ng, Wai-Yee; Fook-Chong, Stephanie; Tan, Bien-Keem; Chong, Si-Jack; Hwee, Jolie; Tay, Sook-Muay

    2017-03-01

    Diabetic burns patients may be at risk of worse clinical outcomes. This study aims to further investigate the impact of diabetes mellitus on clinical outcomes in burns patients in Singapore. A 3-year retrospective review was performed at the Singapore General Hospital Burns Centre (2011-2013). Pure inhalational burns were excluded. Diabetic (N=53) and non-diabetic (N=533) patients were compared, and the impact of diabetes on clinical outcomes, adjusting for confounders, was investigated using multivariate logistic regression. The diabetic group had a significantly higher incidence of wound infection and severe renal impairment, as well as a longer length of stay, higher number of operations and higher rate of unplanned readmission. ICU admission was significantly associated with hyperglycaemia (OR 5.44 [2.61-11.35], p<0.001) and a higher total body surface area of burn (OR per 1% TBSA 1.07 [1.05-1.09], p<0.001). Unplanned readmission was significantly associated with wound infection (OR 4.29 [1.70-10.83], p=0.002), and mortality associated with a higher TBSA (OR per 1% TBSA 1.1 [1.07-1.14], p<0.001). After adjusting for confounders, diabetes mellitus was not significantly associated with unplanned readmission or mortality. Diabetic burns patients have an increased risk of worse clinical outcomes, including wound infections, renal impairment and longer length of stay. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  1. Evaluation of New-Onset Diabetes in Patients Presenting Emergency Service with a Diabetic Ketoacidosis Attack

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    Yavuz Yiğit

    2013-12-01

    Full Text Available Aim: The aim of this study was to investigate the rate of new-onset diabetes mellitus (DM in patients presenting to our emergency department with diabetic ketoacidosis. Methods: We retrospectively evaluated hospital records of patients who presented to the Emergency Department at Istanbul Goztepe Research and Training Hospital between 01 April 2009 and 01 April 2011 and were diagnosed with diabetic ketoacidosis. 57 patients having complete clinical data were included in the study. Results: 45.6%of patients had type 1 DM, 33.3%- type 2 DM, and 21%of them were with new-onset DM. No statistically significant difference was found between type 1 DM, type 2 DM and new-onset DM patients with respect to arterial blood pH and HCO3 levels and serum sodium, potassium and plasma glucose levels at presentation as well as time of presentation (p>0.05, while HbA1c levels showed statistically significant difference in new-onset DM patients. Conclusion: No statistically significant difference was found between types of DM in patients diagnosed with diabetic ketoacidosis except for precipitating factors, age and HbA1c. Detecting high blood glucose levels in patients presenting to emergency room for reasons other than DM is not a rare condition. Cautious evaluation and recognition of these patients in emergency room for the possibility of undiagnosed DM is important for prevention of future diabetic ketoacidosis episodes. (The Medical Bulletin of Haseki 2013; 51: 168-72

  2. Retinal micropseudocysts in diabetic retinopathy: prospective functional and anatomic evaluation.

    Science.gov (United States)

    Forte, Raimondo; Cennamo, Gilda; Finelli, Maria Luisa; Bonavolontà, Paola; Greco, Giovanni Maria; de Crecchio, Giuseppe

    2012-01-01

    To evaluate the prevalence, progression and functional predictive value of retinal micropseudocysts (MPCs) in diabetic patients. Prospective controlled observational study. From among all the type 2 diabetic patients evaluated during a period of 5 months between September 2009 and January 2010, we enrolled all patients with retinal MPCs at spectral-domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) not previously treated for diabetic retinopathy. Forty diabetic patients without MPCs served as the control group. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), macular sensitivity and stability of fixation at SD-SLO/OCT microperimetry were measured monthly for 12 months. 22/156 patients with type 2 diabetes (14.1%, 32 eyes) met the inclusion criteria. The 95% confidence interval for the prevalence estimate of MPCs was 12.3-16.6%. Mean BCVA, CRT and central retinal sensitivity at baseline were 77.53 ± 2.2 Early Treatment Diabetic Retinopathy Study letters, 242.31 ± 31.0 µm and 15.95 ± 0.61 dB, respectively. Fixation was stable in all cases. Compared to the control group, eyes with MPCs had similar BCVA but greater CRT (p = 0.01) and reduced macular sensitivity (p = 0.001) at baseline and at each follow-up visit. Over time, CRT remained stable in eyes with MPCs, whereas macular sensitivity progressively decreased. MPCs in diabetic retinopathy are associated, temporally or causally, with a progressive reduction of macular sensitivity despite a stable BCVA, CRT and fixation. Copyright © 2011 S. Karger AG, Basel.

  3. Gender equity and health: evaluating the impact of Millennium Development Goal Three on women's health in South Asia.

    Science.gov (United States)

    Shannon, Geordan D; Im, Dana D; Katzelnick, Leah; Franco, Oscar H

    2013-01-01

    Researchers evaluated the progress of Millennium Development Goal Three, which promotes gender equity and empowering women, by assessing the targets for education, employment, and government, and their relation to women's health in South Asia. Researchers obtained data from the United Nations, Inter-Parliamentary Union, International Labor Organization, World Bank, and World Health Organization. First, they performed a literature review including manuscripts that quantified a Millenium Development Goal Three outcome in South Asia and were published after 1991. They derived women's health outcomes from World Health Organization databases. Spearman's rank test was used to evaluate the relationship between change in gender parity and change in women's health outcomes. South Asia's average primary education Gender Parity Index (defined as the ratio of girls to boys enrolled in primary, secondary, and tertiary education and expressed as a value between 0 and 1.0) improved from 0.73 (SD 0.34) to 0.92 (SD 0.13) between 2000 and 2008. Secondary and tertiary education had a lower Gender Parity Index (average 2008 Gender Parity Index 0.87 (SD 0.21) and 0.59 (SD 0.23), respectively), but had also improved from 2000 (average Gender Parity Index = 0.77, SD 0.38) to 2008 (average Gender Parity Index = 0.52, SD 0.11). An average proportion of 22.1% (SD 12.58) of women participated in waged, non-agricultural employment and 16.6% (SD 10.3) in national parliaments. No clear association was found between change in gender equity and women's health in South Asia between 2000 and 2008. Some progress has been made toward gender equity in South Asia, although the results have been mixed and inequities persist, especially in employment and government. While gender equity does not appear to have been related to female health outcomes, both must be addressed simultaneously as priority development targets and remain prerequisites to achieving the overall Millennium Development Goals

  4. Night Time Light Satellite Data for Evaluating the Socioeconomics in Central Asia

    Science.gov (United States)

    Li, S.; Zhang, T.; Yang, Z.; Li, X.; Xu, H.

    2017-09-01

    Using nighttime lights data combined with LandScan population counts and socioeconomic statistics, dynamic change was monitored in the social economy of the five countries in Central Asia, from 1993 to 2012. In addition, the spatial pattern of regional historical development was analyzed, using this data. The countries included in this study were Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan and Turkmenistan. The economic development in these five Central Asian countries, the movement of the economic center, the distribution of poor areas and the night light development index (NLDI) were studied at a relatively fine spatial scale. In addition, we studied the relationship between the per capita lighting and per capita GDP at the national scale, finding that the per capital lighting correlated with per capita GDP. The results of this study reflect the socioeconomic development of Central Asia but more importantly, show that nighttime light satellite images are an effective tool for monitoring spatial and temporal social economic parameters.

  5. Evaluating the Marginal Land Resources Suitable for Developing Bioenergy in Asia

    Directory of Open Access Journals (Sweden)

    Jingying Fu

    2014-01-01

    Full Text Available Bioenergy from energy plants is an alternative fuel that is expected to play an increasing role in fulfilling future world energy demands. Because cultivated land resources are fairly limited, bioenergy development may rely on the exploitation of marginal land. This study focused on the assessment of marginal land resources and biofuel potential in Asia. A multiple factor analysis method was used to identify marginal land for bioenergy development in Asia using multiple datasets including remote sensing-derived land cover, meteorological data, soil data, and characteristics of energy plants and Geographic Information System (GIS techniques. A combined planting zonation strategy was proposed, which targeted three species of energy plants, including Pistacia chinensis (P. chinensis, Jatropha curcas L. (JCL, and Cassava. The marginal land with potential for planting these types of energy plants was identified for each 1 km2 pixel across Asia. The results indicated that the areas with marginal land suitable for Cassava, P. chinensis, and JCL were established to be 1.12 million, 2.41 million, and 0.237 million km2, respectively. Shrub land, sparse forest, and grassland are the major classifications of exploitable land. The spatial distribution of the analysis and suggestions for regional planning of bioenergy are also discussed.

  6. Evaluation of modeled vertical aerosol distributions over east-Asia using in-situ and satellite data during summer 2008

    Science.gov (United States)

    Quennehen, Boris; Raut, Jean-Christophe; Law, Kathy S.; Thomas, Jennie L.; Ancellet, Gérard; Bazureau, Ariane; Daskalakis, Nikos; Kim, Sang-Woo; Yoon, Soon-Chang; Zhu, Tong; Pelon, Jacques

    2013-04-01

    As part of the EU ECLIPSE project, which aims to quantify the climate impact of short lived climate forcers (SLCFs), including aerosols, black carbon and ozone, regional models are being used to evaluate global model performance for specific case studies. Here, we present results using regional WRF-Chem simulations over east-Asia. Results are compared to data from field campaigns which took place in summer 2008 and from long-term measurement stations. This study will, in a first step, evaluate the ability of the model to simulate aerosol physical, chemical and optical properties, with a focus on pollution layers. In a second step, the radiative impact of such layers over east-Asia will be investigated as a function of their position relative to clouds. The WRF-Chem regional model was run using MOZART gas phase chemistry and the MOSAIC aerosol scheme and was evaluated against available measurements for the period August to September 2008. The model was run using ECLIPSE anthropogenic and GFEDv3.1 fire emissions for 2008, while initial and boundary conditions were specified from the TM4 global chemical transport model. The radiative impact of pollution aerosol layers has already been investigated but less is known about the influence of vertical layering in the atmosphere. Such layers might have different radiative impacts whether they are below or above clouds and in that sense, a better understanding of their spatial extent is critical. Information about pollution aerosol layers and clouds optical properties and positions over East-Asia are determined using observations from CALIPSO. The radiative impact of these layers is simulated and compared to the observations. In addition to satellite observations, model results are evaluated against trace gas and aerosol data from aircraft campaigns over eastern Asia in summer 2008 (e.g., CAREBEIJING and CAPMEX) and ground-based measurements (e.g., NIES and ABC). In this study, we assess aerosol total concentrations and size

  7. Hypertension and Diabetes Mellitus Program evaluation on user's view.

    Science.gov (United States)

    da Silva, Juliana Veiga Mottin; Mantovani, Maria de Fátima; Kalinke, Luciana Puchalski; Ulbrich, Elis Martins

    2015-01-01

    to evaluate the program proposed by the Reorganization Care Plan for Hypertension and Diabetes Mellitus on user's view, and describe aspects of the trajectory of the participants correlating with the program's evaluation. evaluative study with a qualitative approach conducted in health units with the Family Health Strategy, in a city of the metropolitan region of Curitiba, in the period from September to March, 2012. A total of 30 adults with hypertension and/or Diabetes mellitus were interviewed. Data were analyzed through content analysis. Four categories were identified: Disease diagnosis; Reasons for the program need; Knowledge of the program, and program evaluation. there was the recognition of the orientations, and the monitoring of activities developed, with emphasis in cost reduction for users.

  8. Multi-model evaluation of short-lived pollutant distributions over east Asia during summer 2008

    Science.gov (United States)

    Quennehen, B.; Raut, J.-C.; Law, K. S.; Daskalakis, N.; Ancellet, G.; Clerbaux, C.; Kim, S.-W.; Lund, M. T.; Myhre, G.; Olivié, D. J. L.; Safieddine, S.; Skeie, R. B.; Thomas, J. L.; Tsyro, S.; Bazureau, A.; Bellouin, N.; Hu, M.; Kanakidou, M.; Klimont, Z.; Kupiainen, K.; Myriokefalitakis, S.; Quaas, J.; Rumbold, S. T.; Schulz, M.; Cherian, R.; Shimizu, A.; Wang, J.; Yoon, S.-C.; Zhu, T.

    2016-08-01

    The ability of seven state-of-the-art chemistry-aerosol models to reproduce distributions of tropospheric ozone and its precursors, as well as aerosols over eastern Asia in summer 2008, is evaluated. The study focuses on the performance of models used to assess impacts of pollutants on climate and air quality as part of the EU ECLIPSE project. Models, run using the same ECLIPSE emissions, are compared over different spatial scales to in situ surface, vertical profiles and satellite data. Several rather clear biases are found between model results and observations, including overestimation of ozone at rural locations downwind of the main emission regions in China, as well as downwind over the Pacific. Several models produce too much ozone over polluted regions, which is then transported downwind. Analysis points to different factors related to the ability of models to simulate VOC-limited regimes over polluted regions and NOx limited regimes downwind. This may also be linked to biases compared to satellite NO2, indicating overestimation of NO2 over and to the north of the northern China Plain emission region. On the other hand, model NO2 is too low to the south and west of this region and over South Korea/Japan. Overestimation of ozone is linked to systematic underestimation of CO particularly at rural sites and downwind of the main Chinese emission regions. This is likely to be due to enhanced destruction of CO by OH. Overestimation of Asian ozone and its transport downwind implies that radiative forcing from this source may be overestimated. Model-observation discrepancies over Beijing do not appear to be due to emission controls linked to the Olympic Games in summer 2008.With regard to aerosols, most models reproduce the satellite-derived AOD patterns over eastern China. Our study nevertheless reveals an overestimation of ECLIPSE model mean surface BC and sulphate aerosols in urban China in summer 2008. The effect of the short-term emission mitigation in Beijing

  9. Multi-model evaluation of short-lived pollutant distributions over east Asia during summer 2008

    Directory of Open Access Journals (Sweden)

    B. Quennehen

    2016-08-01

    Full Text Available The ability of seven state-of-the-art chemistry–aerosol models to reproduce distributions of tropospheric ozone and its precursors, as well as aerosols over eastern Asia in summer 2008, is evaluated. The study focuses on the performance of models used to assess impacts of pollutants on climate and air quality as part of the EU ECLIPSE project. Models, run using the same ECLIPSE emissions, are compared over different spatial scales to in situ surface, vertical profiles and satellite data. Several rather clear biases are found between model results and observations, including overestimation of ozone at rural locations downwind of the main emission regions in China, as well as downwind over the Pacific. Several models produce too much ozone over polluted regions, which is then transported downwind. Analysis points to different factors related to the ability of models to simulate VOC-limited regimes over polluted regions and NOx limited regimes downwind. This may also be linked to biases compared to satellite NO2, indicating overestimation of NO2 over and to the north of the northern China Plain emission region. On the other hand, model NO2 is too low to the south and west of this region and over South Korea/Japan. Overestimation of ozone is linked to systematic underestimation of CO particularly at rural sites and downwind of the main Chinese emission regions. This is likely to be due to enhanced destruction of CO by OH. Overestimation of Asian ozone and its transport downwind implies that radiative forcing from this source may be overestimated. Model-observation discrepancies over Beijing do not appear to be due to emission controls linked to the Olympic Games in summer 2008.With regard to aerosols, most models reproduce the satellite-derived AOD patterns over eastern China. Our study nevertheless reveals an overestimation of ECLIPSE model mean surface BC and sulphate aerosols in urban China in summer 2008. The effect of the short-term emission

  10. Diabetic retinopathy: retina-specific methods for maintenance of diabetic rodents and evaluation of vascular histopathology and molecular abnormalities

    Science.gov (United States)

    Veenstra, Alexander; Liu, Haitao; Lee, Chieh Allen; Du, Yunpeng; Tang, Jie; Kern, Timothy S.

    2015-01-01

    Diabetic retinopathy is a major cause of visual impairment, which continues to increase in prevalence as more and more people develop diabetes. Despite the importance of vision, the retina is one of the smallest tissues in the body, and specialized techniques to study the retinopathy have been developed. This chapter will summarize several methods used to (i) induce diabetes, (ii) maintain the diabetic animals throughout the months required for the development of typical vascular histopathology, (iii) evaluate vascular histopathology of diabetic retinopathy, and (iv) quantitate abnormalities implicated in the development of the retinopathy. PMID:26331759

  11. Evaluation of the difference in caries experience in diabetic and non-diabetic children—A case control study

    Science.gov (United States)

    Lai, Stefano; Cagetti, Maria Grazia; Cocco, Fabio; Cossellu, Dina; Meloni, Gianfranco; Lingström, Peter

    2017-01-01

    Aim To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status. Methods Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4–14 years) were enrolled. The diabetic children were divided: a) 20 children in good metabolic control (Hb1ac≤7.5) and b) 48 children in bad metabolic control (Hb1ac>7.5). Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse. Results Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively) and in subjects in bad metabolic control (p = 0.03 and pnon-diabetic children (p = 0.04). No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (pdifference for the main cariogenic bacteria was found between diabetic and non-diabetic subjects (pdifferences between diabetic and non-diabetic subjects and between diabetic subjects in good and bad metabolic control (pDiabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk. PMID:29190700

  12. Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

    Directory of Open Access Journals (Sweden)

    Stefano Lai

    Full Text Available To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status.Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4-14 years were enrolled. The diabetic children were divided: a 20 children in good metabolic control (Hb1ac≤7.5 and b 48 children in bad metabolic control (Hb1ac>7.5. Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse.Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively and in subjects in bad metabolic control (p = 0.03 and p<0.01, respectively. Oral hygiene habits were similar, except for the use of fluoridated adjuvants, higher in non-diabetic children (p = 0.04. No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (p<0.01. Significant difference for the main cariogenic bacteria was found between diabetic and non-diabetic subjects (p<0.05. The pH values showed statistically significant differences between diabetic and non-diabetic subjects and between diabetic subjects in good and bad metabolic control (p<0.01.Diabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

  13. Evaluation of a naturopathic nutrition program for type 2 diabetes

    Science.gov (United States)

    Oberg, Erica B.; Bradley, Ryan D.; Allen, Jason; McCrory, Megan A.

    2011-01-01

    Objective To test feasibility, acceptability, and preliminary effectiveness of a naturopathic dietary intervention in patients with Type 2 diabetes. Methods: Prospective observational pilot study evaluating the change in clinical and patient-centered outcome measures following a 12-week individualized and group dietary education program delivered in naturopathic primary care. Results HbA1c improved in all participants (n=12); mean - 0.4% +/– .49% SD, (p=0.02). Adherence to healthful eating increased from 3.5 d/wk to 5.3 d/wk (p=0.05). Specific nutritional behavior modification included: days/week consuming ≥5 servings of fruit/vegetables (p=0.01), attention to fat intake (p=0.05), and –11.3% carbohydrate reduction. Measures of physical activity, self-efficacy and self-management also improved significantly. Conclusion A naturopathic dietary approach to diabetes appears to be feasible to implement among Type 2 diabetes patients. The intervention may also improve self-management, glycemic control, and have influences in other domains of self-care behaviors. Clinical trials evaluating naturopathic approaches to Type 2 diabetes are warranted. PMID:21742282

  14. Evaluating the genetic impact of South and Southeast Asia on the peopling of Bangladesh.

    Science.gov (United States)

    Sultana, Gazi Nurun Nahar; Sharif, Mohd Istiaq; Asaduzzaman, Md; Chaubey, Gyaneshwer

    2015-11-01

    Despite rapidly growing understandings and dependency on single nucleotide polymorphisms (SNPs), highly variable autosomal short tandem repeats (STRs) are still regarded as the most established method to differentiate individuals at forensic level. Here with large number of various ethnic groups we undertook this study to reveal the genetic structure of the most densely populated part of South Asia i.e. the Bangladesh. The purpose of this work was to estimate population parameters based on the allele frequencies obtained for 15 polymorphic autosomal STR loci investigated in caste and tribal populations from Bangladesh (n=706). We compared the results in a broader context by merging 24 different populations of Asia to pertain their affinity. Various statistical analyses suggested a clear cut demarcation of tribal and non-tribal in Bangladesh. Moreover, beside the phylogenetic structure of the studied populations, it is found that the mean heterozygosity value was highest among the populations of Bangladesh, likely because of gene flow from different directions. However, Tonchangya, Adi and Khumi showed sign of genetic isolation and reduced diversity, possibly as a result of genetic drift and/or strong founder effects working on small endogamous populations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. An Evaluation of the Impact of the U.S. Rebalancing Policy on the Stability of Northeast Asia

    Science.gov (United States)

    2015-12-01

    reabalance, northeast asia, security, diplomatic , military, nuclear, stability, instability 15. NUMBER OF PAGES 81 16. PRICE CODE 17. SECURITY...ON THE STABILITY OF NORTHEAST ASIA Jun Hyeok Son Major, Republic of Korea Air Force B.A., Republic of Korea Air Force Academy , 2002...14 II. THE DIPLOMATIC ASPECT OF THE ASIA REBALANCING POLICY AND ITS IMPLICATION ON NORTHEAST ASIA ......................17 A. THE U.S

  16. Leveraging Process Evaluation for Project Development and Sustainability: The Case of the CAMPUS Asia Program in Korea

    Science.gov (United States)

    Kim, Seon-Joo

    2017-01-01

    CAMPUS Asia (Collective Action for Mobility Program of University Students in Asia) is a student-exchange program designed to promote student mobility between South Korea, China, and Japan. Begun in 2011, the program aims to foster the next generation of leaders in Asia by nurturing young talents with shared visions. This article provides an…

  17. Evaluation of VIIRS, GOCI, and MODIS Collection 6 AOD Retrievals Against Ground Sunphotometer Observations Over East Asia

    Science.gov (United States)

    Xiao, Q.; Zhang, H.; Choi, M.; Li, S.; Kondragunta, S.; Kim, J.; Holben, B.; Levy, R. C.; Liu, Y.

    2016-01-01

    Persistent high aerosol loadings together with extremely high population densities have raised serious air quality and public health concerns in many urban centers in East Asia. However, ground-based air quality monitoring is relatively limited in this area. Recently, satellite-retrieved Aerosol Optical Depth (AOD) at high resolution has become a powerful tool to characterize aerosol patterns in space and time. Using ground AOD observations from the Aerosol Robotic Network (AERONET) and the Distributed Regional Aerosol Gridded Observation Networks (DRAGON)-Asia Campaign, as well as from handheld sunphotometers, we evaluated emerging aerosol products from the Visible Infrared Imaging Radiometer Suite (VIIRS) aboard the Suomi National Polar-orbiting Partnership (S-NPP), the Geostationary Ocean Color Imager (GOCI) aboard the Communication, Ocean, and Meteorology Satellite (COMS), and Terra and Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) (Collection 6) in East Asia in 2012 and 2013. In the case study in Beijing, when compared with AOD observations from handheld sunphotometers, 51% of VIIRS Environmental Data Record (EDR) AOD, 37% of GOCI AOD, 33% of VIIRS Intermediate Product (IP) AOD, 26% of Terra MODIS C6 3km AOD, and 16% of Aqua MODIS C6 3km AOD fell within the reference expected error (EE) envelope (+/-0.05/+/- 0.15 AOD). Comparing against AERONET AOD over the JapanSouth Korea region, 64% of EDR, 37% of IP, 61% of GOCI, 39% of Terra MODIS, and 56% of Aqua MODIS C6 3km AOD fell within the EE. In general, satellite aerosol products performed better in tracking the day-to-day variability than tracking the spatial variability at high resolutions. The VIIRS EDR and GOCI products provided the most accurate AOD retrievals, while VIIRS IP and MODIS C6 3km products had positive biases.

  18. Evaluation of US Veterans Nutrition Education for Diabetes Prevention.

    Science.gov (United States)

    Erickson, Megan; Braun, Katie; List, Riesa; Utech, Anne; Moore, Carolyn; White, Donna L; Garcia, Jose M

    2016-09-01

    Evaluate the effectiveness of nutrition education interventions for diabetes prevention. Retrospective cohort design. Tertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database. Prediabetic, adult veterans (n = 372), mostly men (94.4%, n = 351). Visits with existing nutrition education classes were collected. diabetes status; predictors: visits/encounters, age, body mass index, weight change, and hemoglobin A1c. Cox proportional hazards method, χ(2) test, and logistic regression. In this sample, prediabetic veterans who received nutrition education were less likely to develop diabetes when compared with prediabetic veterans who did not receive nutrition education (hazard ratio, 0.71; 95% confidence interval, 0.55-0.92; P Nutrition education was significantly associated with preventing the progression from prediabetes to diabetes in US Veterans participating in a nutrition education intervention at the Michael E. DeBakey Veterans Affairs Medical Center. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

  19. Theming Asia

    NARCIS (Netherlands)

    Erb, Maribeth; Ong, Chin Ee

    2017-01-01

    This paper introduces a special issue on Theme Parks in Asia with reflections on how the various theoretical ideas on theming and theme parks that are found in the social science literature can help us to understand the proliferation of theming and theme parks in contemporary Asia. How does theming

  20. [Evaluation of corneal endothelium following cataract surgery in diabetic patients].

    Science.gov (United States)

    Langwińska-Wośko, Ewa; Chociszewska-Nitka, Anna; Zielińska, Edyta; Hapunik, Adam

    2004-01-01

    The aim of this study was to evaluate the influence of cataract surgery on the condition of corneal endothelium, in diabetic patients. We examined 103 patients (103 eyes) after cataract surgery (64 women and 39 men), at the age between 49 and 89. In our study we didn't involve any patients with intra or post-surgery complications. Using Specular Microscope SP-1000 corneal endothelium was examined before cataract surgery and in the long-term follow-up: 7, 30 and 90 days after surgery. The patients were divided into two groups: suffering from diabetes (54) and matched control group--non-diabetic patients with cataract (49). The same patients were also divided depending on the type of surgical technique: phacoemulsification (42) or extracapsular cataract extraction (61). The mean percent loss of corneal endothelium cells, due to surgery in diabetic patients was: 11.31% after 7 days, 13.99% after 30 and 15.38% after 90 days. In the control group: 5.45% after 7 days, 8.66% after 30 and 11.33% after 90 days. The mean percent loss of corneal endothelium cells after phacoemulsification was: 10.10% after 7 days, 13.21% after 30 and 15.87% after 90 days; after extra-capsular cataract extraction: 6.84% after 7 days, 9.71% after 30 and 11.48% after 90 days. Differences between mean value of corneal endothelial cells in diabetic patients compared with control group, were statistically essential 7 and 30 days after cataract surgery, and near such assessment 90 days after surgery. There were no statistically essential differences between endothelial cells density in both operated groups, in relation to type of operation (phacoemulsification and extra-capsular cataract extraction). Above results are the evidence, that cataract surgery is a big trauma for cornea, especially for its endothelium. The operation is mainly dangerous for patients suffering from diabetes. The surgeon should be aware of the above threat during cataract surgery in diabetic patients, and therefore should

  1. A SHORT-TERM EVALUATIVE STUDY OF DIABETIC NEPHROPATHY PATIENT

    Directory of Open Access Journals (Sweden)

    A Vaishya

    2012-10-01

    Full Text Available Background: Rising diabetes incidence globally and consequently diabetic nephropathy is a major concern. Being chronic disease patients are continuously monitored. Clinical improvement of major sign/symptoms in short course of therapy may lead to satisfaction of the patient’s that will increase better compliance to the treatment. Objective: To evaluate signs/symptoms and GFR status of diabetic nephropathy patient in short course of treatment therapy and nutritional management Material & Methods: All 170 incident cases of diabetic nephropathy (DN based on glomerular filtration rate and creatinine level registered on pre-fixed dates during May 2007 to May 2010, but 127 followed inclusion criteria. Patients were recorded for demographic, biological & biochemical characteristics and presenting major sign/symptoms at registration time; further, evaluated for presenting sign/symptoms after six months of medicine and dietary intervention. Statistical Analysis: Statistical significance for association was tested by c2 (unrelated samples and McNemar (related samples and for the differences of number of signs/symptoms by Mann Whitney (unrelated samples and Wilcoxon Signed Rank tests (related samples. Results: No statistical association was seen between GFR status and presence of edema/swelling in any part of the body. After six months of treatment and dietary management, the edema/swelling presenting in 69.6% of the cases was found only in 33.3%. Pedal edema was found in 43.1%; while either eye lid or facial swelling was in 12.9% of the cases but after six months of drug treatment and dietary care these were present only in 18.6% and 3.9% cases respectively. GFR status of one third cases also improved after 6 months, while 57.8% were unchanged; very few (9.8% deteriorated. The GFR improvement was more in cases reporting with GFR 60 and above. Conclusion: Though, for the drug compliance and dietary intake patient’s statement was believed, after six

  2. Remotely Sensed Data Informs Red List Evaluations and Conservation Priorities in Southeast Asia.

    Science.gov (United States)

    Li, Binbin V; Hughes, Alice C; Jenkins, Clinton N; Ocampo-Peñuela, Natalia; Pimm, Stuart L

    2016-01-01

    The IUCN Red List has assessed the global distributions of the majority of the world's amphibians, birds and mammals. Yet these assessments lack explicit reference to widely available, remotely-sensed data that can sensibly inform a species' risk of extinction. Our first goal is to add additional quantitative data to the existing standardised process that IUCN employs. Secondly, we ask: do our results suggest species of concern-those at considerably greater risk than hitherto appreciated? Thirdly, these assessments are not only important on a species-by-species basis. By combining distributions of species of concern, we map conservation priorities. We ask to what degree these areas are currently protected and how might knowledge from remote sensing modify the priorities? Finally, we develop a quick and simple method to identify and modify the priority setting in a landscape where natural habitats are disappearing rapidly and so where conventional species' assessments might be too slow to respond. Tropical, mainland Southeast Asia is under exceptional threat, yet relatively poorly known. Here, additional quantitative measures may be particularly helpful. This region contains over 122, 183, and 214 endemic mammals, birds, and amphibians, respectively, of which the IUCN considers 37, 21, and 37 threatened. When corrected for the amount of remaining natural habitats within the known elevation preferences of species, the average sizes of species ranges shrink to amphibian ranges are conservation priorities.

  3. Evaluation of NMME temperature and precipitation bias and forecast skill for South Asia

    Science.gov (United States)

    Cash, Benjamin A.; Manganello, Julia V.; Kinter, James L.

    2017-08-01

    Systematic error and forecast skill for temperature and precipitation in two regions of Southern Asia are investigated using hindcasts initialized May 1 from the North American Multi-Model Ensemble. We focus on two contiguous but geographically and dynamically diverse regions: the Extended Indian Monsoon Rainfall (70-100E, 10-30 N) and the nearby mountainous area of Pakistan and Afghanistan (60-75E, 23-39 N). Forecast skill is assessed using the Sign test framework, a rigorous statistical method that can be applied to non-Gaussian variables such as precipitation and to different ensemble sizes without introducing bias. We find that models show significant systematic error in both precipitation and temperature for both regions. The multi-model ensemble mean (MMEM) consistently yields the lowest systematic error and the highest forecast skill for both regions and variables. However, we also find that the MMEM consistently provides a statistically significant increase in skill over climatology only in the first month of the forecast. While the MMEM tends to provide higher overall skill than climatology later in the forecast, the differences are not significant at the 95% level. We also find that MMEMs constructed with a relatively small number of ensemble members per model can equal or outperform MMEMs constructed with more members in skill. This suggests some ensemble members either provide no contribution to overall skill or even detract from it.

  4. Accounting for CO2 variability over East Asia with a regional joint inversion system and its preliminary evaluation

    Science.gov (United States)

    Kou, Xingxia; Tian, Xiangjun; Zhang, Meigen; Peng, Zhen; Zhang, Xiaoling

    2017-10-01

    A regional surface carbon dioxide (CO2) flux inversion system, the Tan-Tracker-Region, was developed by incorporating an assimilation scheme into the Community Multiscale Air Quality (CMAQ) regional chemical transport model to resolve fine-scale CO2 variability over East Asia. The proper orthogonal decomposition-based ensemble four-dimensional variational data assimilation approach (POD-4DVar) is the core algorithm for the joint assimilation framework, and simultaneous assimilations of CO2 concentrations and surface CO2 fluxes are applied to help reduce the uncertainty in initial CO2 concentrations. A persistence dynamical model was developed to describe the evolution of the surface CO2 fluxes and help avoid the "signal-to-noise" problem; thus, CO2 fluxes could be estimated as a whole at the model grid scale, with better use of observation information. The performance of the regional inversion system was evaluated through a group of single-observation-based observing system simulation experiments (OSSEs). The results of the experiments suggest that a reliable performance of Tan-Tracker-Region is dependent on certain assimilation parameter choices, for example, an optimized window length of approximately 3 h, an ensemble size of approximately 100, and a covariance localization radius of approximately 320 km. This is probably due to the strong diurnal variation and spatial heterogeneity in the fine-scale CMAQ simulation, which could affect the performance of the regional inversion system. In addition, because all observations can be artificially obtained in OSSEs, the performance of Tan-Tracker-Region was further evaluated through different densities of the artificial observation network in different CO2 flux situations. The results indicate that more observation sites would be useful to systematically improve the estimation of CO2 concentration and flux in large areas over the model domain. The work presented here forms a foundation for future research in which a

  5. A standardized clinical evaluation of phenotypic diversity in diabetic polyneuropathy.

    Science.gov (United States)

    Scholz, Joachim; Rathmell, James P; David, William S; Chad, David A; Broderick, Alithia C; Perros, Stephen G; Shin, Naomi S; Wells, Jenna L; Davis, John B; DiMaggio, Charles J; Wang, Shuang; Tate, Simon N

    2016-10-01

    Diabetic polyneuropathy (DPN) is a major cause of neuropathic pain and a frequent target condition in analgesic treatment trials. Differences in the clinical symptoms and signs associated with DPN suggest distinct pathophysiological mechanisms underlying nerve damage and dysfunction that are likely to have therapeutic relevance. The aim of this study was to develop a tool for the bedside assessment of painful neuropathies such as DPN that captures the diversity of phenotypes. Sixty-one patients with type 2 diabetes and painful neuropathy, 19 patients with painless DPN, 25 patients with type 2 diabetes but no clinical evidence of neuropathy, and 20 healthy control subjects completed a structured interview (47 items) and a standardized physical examination (39 items). After analyzing critical features of pain and painless symptoms and examining the outcome of physical tests of sensory function, we determined principal components of the phenotypic variance among patients. Increased sensitivity to mechanical or thermal stimuli and, to a lesser extent, the sensory quality of pain or paresthesia were the most discriminating elements of DPN phenotypes. Correlation patterns of symptoms and signs indicated the involvement of functionally distinct nerve fiber populations. We combined interview questions and physical tests identifying these differences in a shortened assessment protocol that we named Standardized Evaluation of Pain and Somatosensory Function (StEPS). The protocol StEPS generates a phenotypic profile of patients with neuropathy. Separate intensity ratings for spontaneous painful symptoms and pain evoked by standard stimuli support a detailed documentation of neuropathic pain and its response to analgesic treatment.

  6. Autoradiographic thyroid evaluation in short-term experimental diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Nascimento-Saba C.C.A.

    1998-01-01

    Full Text Available Previous studies have shown that in vitro thyroid peroxidase (TPO iodide oxidation activity is decreased and thyroid T4-5'-deiodinase activity is increased 15 days after induction of experimental diabetes mellitus (DM. In the present study we used thyroid histoautoradiography, an indirect assay of in vivo TPO activity, to determine the possible parallelism between the in vitro and in vivo changes induced by experimental DM. DM was induced in male Wistar rats (about 250 g body weight by a single ip streptozotocin injection (45 mg/kg, while control (C animals received a single injection of the vehicle. Seven and 30 days after diabetes induction, each diabetic and control animal was given ip a tracer dose of 125I (2 µCi, 2.5 h before thyroid excision. The glands were counted, weighed, fixed in Bouin's solution, embedded in paraffin and cut. The sections were stained with HE and exposed to NTB-2 emulsion (Kodak. The autohistograms were developed and the quantitative distribution of silver grains was evaluated with a computerized image analyzer system. Thyroid radioiodine uptake was significantly decreased only after 30 days of DM (C: 0.38 ± 0.05 vs DM: 0.20 ± 0.04%/mg thyroid, P<0.05 while in vivo TPO activity was significantly decreased 7 and 30 days after DM induction (C: 5.3 and 4.5 grains/100 µm2 vs DM: 2.9 and 1.6 grains/100 µm2, respectively, P<0.05 . These data suggest that insulin deficiency first reduces in vivo TPO activity during short-term experimental diabetes mellitus

  7. Knowledge evaluation and educating diabetic patients on self foot ...

    African Journals Online (AJOL)

    Background: Diabetic foot infection, ulcers and amputations remain very common in diabetics worldwide and extremely affect patients' quality of life. The objective of this survey was to assess the level of knowledge and educate diabetic patients on self foot care at diabetic outpatient clinic at Muhimbili National Hospital.

  8. [Evaluation of a screening programme for diabetic retinopathy (DODIA study)].

    Science.gov (United States)

    Aubert, Jean-Pierre; Massin, Pascale; Audran, Ghislaine; Ben Mehidi, Amina; Bernit, Blandine; Bouée, Stéphane; Bouhassira, Myriam; Bourovitch, Jean-Claude; Erginay, Ali; Eschwege, Evelyne; Jamet, Marina; Marre, Michel; Nougairède, Michel; Tcherny-Lessenot, Stéphanie

    2007-06-15

    In France, 43% to 63% of diabetics have an annual fundoscopy. Do the new screening tools, coupled with teletransmission of the images, allow for satisfying ophthalmological screening? It is an important matter given the foreseeable reduction in the number of French ophthalmologists in the forthcoming years. To measure the quality of screening for diabetic retinopathy (DR), in the framework of a network, by the provision of a retinograph by numeric camera (with teletransmission of the images and centralised interpretation), in a screening centre located in town. The study evaluated the quality of screening obtained in two comparable groups of general practitioners, one using the retinograph and the other using the classical method of screening by ophthalmologist. The screening was targeted at diabetics who had not had a fundoscopy in the preceding year, nor had known DR or a treating ophthalmologist (for the retinography group only). 667 patients were sampled in the retinography group (456 included) and 707 in the control group (426 included) between 1/04/02 and 1/11/02; 417 patients were followed until the end of the study in the 2 groups. A screening examination was considered effective if it was performed within the six months following its request, and by the presence of a report in the file of the general practitioner. The percentage of patients thus screened was 74% in the retinography group and 71,5% in the other group (not significant). 16% of diabetics in the retinography group had DR compared with 10% of patients in the control group. The analysis of the level of satisfaction of patients tended to show a preference for the system of screening by fundal photography. In the framework of a healthcare network, the availability of a retinograph by numeric camera, with the interpretation of photos by teletransmission of the images, obtained a high level of quality of screening for diabetic retinopathy that was at least as good as that obtained by a healthcare

  9. Diabetic nephropathy

    DEFF Research Database (Denmark)

    Rossing, Peter

    2006-01-01

    Diabetic nephropathy has become a worldwide epidemic, accounting for approximately one third of all cases of end-stage renal disease. With increasing prevalence of diabetes particularly in Asia, and a global prevalence of microalbuminuria of 39%, the problem is expected to grow. Improved management...... of diabetes aimed at improved glycemic control, to avoid initiation of diabetic nephropathy, and antihypertensive treatment blocking the renin-angiotensin system, to avoid its progression, need to be implemented, particularly in high-risk patients....

  10. Challenges in the Energy Sector in Eastern Europe and Central Asia: An Evaluation of 18 Years of Swiss Economic Cooperation

    Directory of Open Access Journals (Sweden)

    Guy Bonvin

    2011-05-01

    Full Text Available Published by Palgrave MacmillanSwitzerland’s State Secretariat for Economic Affairs (SECO has been working in the energy sectors of Eastern Europe and Central Asia since 1992, financing 41 projects to the value of CHF 316 million. In 2009 an independent evaluation was commissioned to assess the effects of these projects in the region and to draw lessons for future project funding. The evaluation found the projects to be highly satisfactory in terms of relevance, satisfactory in terms of effectiveness and sustainability, and — because of external factors relating to governance, transparency and political stability in a country — generally unsatisfactory in terms of efficiency.Lessons drawn from the successful projects will be used to further improve them in the future. With limited financial resources governments are attempting to find a balance between energy security and environmental sustainability. SECO will support this mission by helping to reduce inefficient consumption, to increase the share of renewable energy, to strengthen the sustainability of utility companies and to develop effective energy policies.

  11. Evaluating the patterns of spatiotemporal trends of root zone soil moisture in major climate regions in East Asia

    Science.gov (United States)

    Zohaib, Muhammad; Kim, Hyunglok; Choi, Minha

    2017-08-01

    Root zone soil moisture (RZSM) is a crucial variable in land-atmosphere interactions. Evaluating the spatiotemporal trends and variability patterns of RZSM are essential for discerning the anthropogenic and climate change effects on the regional and global hydrological cycles. In this study, the trends of RZSM, computed by the exponential filter from the European Space Agency's Climate Change Initiative soil moisture, were evaluated in major climate regions of East Asia from 1982 to 2014. Moreover, the trends of RZSM were compared to the trends of precipitation (P), skin temperature (Tskin), and actual evapotranspiration (AET) to investigate how they influence the RZSM trends in each climate region. Drying trends were predominant in arid and continental regions, whereas wetting trends were found in the tropical and temperate regions. The increasing trends of Tskin and AET cause drying in arid and continental regions, whereas in tropical regions, these cause wetting trends, which might be due to convective P. In temperate regions, despite decreasing P and increasing Tskin, the RZSM trend was increasing, attributed to the intensive irrigation activities in these regions. This is probably the first time to analyze the long-term trends of RZSM in different climate regions. Hence, the results of this study will improve our understanding of the regional and global hydrological cycles. Despite certain limitations, the results of this study may be useful for improving and developing climate models and predicting long-term vast scale natural disasters such as drought, dust outbreaks, floods, and heat waves.

  12. Features in Angiographic Evaluation of the Diabetic Patient

    Directory of Open Access Journals (Sweden)

    Taisia Tiron Andreea

    2014-09-01

    Full Text Available Currently it is estimated that there are over 382 million patients with diabetes worldwide and their number is increasing, which makes this metabolic disorder the most common non-contagious disease, particularly related to obesity and physical inactivity. There is a close relationship between diabetes and cardiovascular disease, statistics showing that over 50% of deaths in patients with diabetes are produced by cardiovascular complications. This requires a close collaboration between diabetologists and cardiologists. The mortality caused by atherosclerotic complications is 65-80% for diabetic patients compared to 33% in non-diabetic patients. Moreover, 20% of the patients requiring coronary revascularization procedures are diabetics and over 30% of patients with angiographic exploration have diabetes. Among the patients with diabetes the coronary lesions are present in 50% of cases and the peripheral arteries lesions in 30% of cases.

  13. Evaluation of Smoking Status among Diabetes Patients in the State ...

    African Journals Online (AJOL)

    HP

    Between June 1st 2010 and June 30th 2011, all medical records of type 1 and 2 diabetes patients were reviewed to assess the prevalence of smoking. Results: Of 2547 diabetes patients, 447 patients were excluded from the analysis as their smoking status was unknown, leaving 2100 diabetes patients whose smoking ...

  14. Diabetes self-management: A post-intervention evaluation of ...

    African Journals Online (AJOL)

    The prevalence of diabetes mellitus in South Africa has increased drastically over the last two decades and ranks third in terms of mortality and morbidity for the general population; with an estimated 2.28 million people in South Africa living with diabetes in 2014. The effectiveness of diabetes management ultimately ...

  15. Consumer evaluation of imported organic food products in emerging economies in Asia

    DEFF Research Database (Denmark)

    Pedersen, Susanne; Aschemann-Witzel, Jessica; Thøgersen, John

    of organic food products to these markets from countries, where the organic markets are more established and able to provide consumers with safe products. It is well-known that consumers are more willing to buy products originating from some countries than others and that they perceive some favourite brand...... & Romeo, 1992). Country of origin (COO) has consistently been found among the extrinsic cues consumers use in product evaluations, along with price and brand name (Dekhili & Achabou, 2014; Essoussi & Zahaf, 2009; Liu & Johnson, 2005; Mauracher, Tempesta, & Vecchiato, 2013), shaping consumers’ perceptions...... products from Thailand – especially if they were a part of the ”Thai Royal Project”. In both Thailand and China many of the consumers perceived products’ COO as important, but price, brands and familiarity with the product also influenced their decision. COO was especially considered when evaluating...

  16. Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

    Science.gov (United States)

    Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

    2016-10-01

    Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  17. Evaluation of topographical and seasonal feature using GPM IMERG and TRMM 3B42 over Far-East Asia

    Science.gov (United States)

    Kim, Kiyoung; Park, Jongmin; Baik, Jongjin; Choi, Minha

    2017-05-01

    The acquisition of accurate precipitation data is essential for analyzing various hydrological phenomena and climate change. Recently, the Global Precipitation Measurement (GPM) satellites were launched as a next-generation rainfall mission for observing global precipitation characteristics. The main objective in this study is to assess precipitation products from GPM, especially the Integrated Multi-satellitE Retrievals (GPM-3IMERGHH) and the Tropical Rainfall Measurement Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA), using gauge-based precipitation data from Far-East Asia during the pre-monsoon and monsoon seasons. Evaluation was performed by focusing on three different factors: geographical aspects, seasonal factors, and spatial distributions. In both mountainous and coastal regions, the GPM-3IMERGHH product showed better performance than the TRMM 3B42 V7, although both rainfall products showed uncertainties caused by orographic convection and the land-ocean classification algorithm. GPM-3IMERGHH performed about 8% better than TRMM 3B42 V7 during the pre-monsoon and monsoon seasons due to the improvement of loaded sensor and reinforcement in capturing convective rainfall, respectively. In depicting the spatial distribution of precipitation, GPM-3IMERGHH was more accurate than TRMM 3B42 V7 because of its enhanced spatial and temporal resolutions of 10 km and 30 min, respectively. Based on these results, GPM-3IMERGHH would be helpful for not only understanding the characteristics of precipitation with high spatial and temporal resolution, but also for estimating near-real-time runoff patterns.

  18. Evaluating the Height of Biomass Burning Smoke Aerosols Retrieved from Synergistic Use of Multiple Satellite Sensors Over Southeast Asia

    Science.gov (United States)

    Lee, Jaehwa; Hsu, N. Christina; Bettenhausen, Corey; Sayer, Andrew M.; Seftor, Colin J.; Jeong, Myeong-Jae; Tsay, Si-Chee; Welton, Ellsworth J.; Wang, Sheng-Hsiang; Chen, Wei-Nai

    2016-01-01

    This study evaluates the height of biomass burning smoke aerosols retrieved from a combined use of Visible Infrared Imaging Radiometer Suite (VIIRS), Ozone Mapping and Profiler Suite (OMPS), and Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) observations. The retrieved heights are compared against space borne and ground-based lidar measurements during the peak biomass burning season (March and April) over Southeast Asia from 2013 to 2015. Based on the comparison against CALIOP, a quality assurance (QA) procedure is developed. It is found that 74 (8184) of the retrieved heights fall within 1 km of CALIOP observations for unfiltered (QA-filtered) data, with root-mean-square error (RMSE) of 1.1 km (0.81.0 km). Eliminating the requirement of CALIOP observations from the retrieval process significantly increases the temporal coverage with only a slight decrease in the retrieval accuracy; for best QA data, 64 of data fall within 1 km of CALIOP observations with RMSE of 1.1 km. When compared with Micro-Pulse Lidar Network (MPLNET) measurements deployed at Doi Ang Khang, Thailand, the retrieved heights show RMSE of 1.7 km (1.1 km) for unfiltered (QA-filtered) data for the complete algorithm, and 0.9 km (0.8 km) for the simplified algorithm.

  19. In Vivo Evaluation of Anti Diabetic, Hypolipidemic, Antioxidative Activities of Saudi Date Seed Extract on Streptozotocin Induced Diabetic Rats.

    Science.gov (United States)

    Hasan, Marghoob; Mohieldein, Abdelmarouf

    2016-03-01

    Phoenix dactylifera (date palm) is major fruit of gulf region. In folk medicine; dates have been traditionally use. The date seed is used as hypoglycaemic, expectorant, tonic, aphrodisiac, antidiarrheic and mouth hygiene. This study intended to evaluate the anti-diabetic, hypolipidaemic and antioxidative activities of date seed extract in diabetes-induced rats. Total of seven groups of rats, consisting of control rats and streptozotocin induced diabetic rats treated with aqueous seed extract in concentration of 100g/L in dosage of 10ml/day/rat. To evaluate the anti-diabetic property, glucose and weight was analysed weekly and at the end of eight week all rats were sacrificed. To evaluate the hypolipidaemic and antioxidative activities, serum cholesterol, triglyceride, malondialdehyde, superoxide dismutase, 8-hydroxy-2'-deoxyguanosine were estimated. Liver enzymes and kidney function tests were performed. Moreover to verify the glycaemic effect; glycated haemoglobin and serum insulin was performed. Aqueous seed extract in concentration of 100 gm/L in dosage of 10ml/day/rat brings a significant reduction of blood glucose levels in diabetic rats in comparison of control rats. There were significant differences in the investigated clinical chemistry and oxidative stress parameters between control and diabetic rats with both seed extract of Ajwa and Sukkari dates. Present study verifies the antidiabetic property, of aqueous seed extracts of two different varieties of dates namely Ajwa and Sukkari of Kingdom of Saudi on streptozotocin induced Diabetic rats. Prolong treatments with the extract restores the function of liver and kidney and balance the oxidative stress condition in diabetic treated rats.

  20. A Self-adaptive Dynamic Evaluation Model for Diabetes Mellitus, Based on Evolutionary Strategies

    Directory of Open Access Journals (Sweden)

    An-Jiang Lu

    2016-03-01

    Full Text Available In order to evaluate diabetes mellitus objectively and accurately, this paper builds a self-adaptive dynamic evaluation model for diabetes mellitus, based on evolutionary strategies. First of all, on the basis of a formalized description of the evolutionary process of diabetes syndromes, using a state transition function, it judges whether a disease is evolutionary, through an excitation parameter. It then, provides evidence for the rebuilding of the evaluation index system. After that, by abstracting and rebuilding the composition of evaluation indexes, it makes use of a heuristic algorithm to determine the composition of the evolved evaluation index set of diabetes mellitus, It then, calculates the weight of each index in the evolved evaluation index set of diabetes mellitus by building a dependency matrix and realizes the self-adaptive dynamic evaluation of diabetes mellitus under an evolutionary environment. Using this evaluation model, it is possible to, quantify all kinds of diagnoses and treatment experiences of diabetes and finally to adopt ideal diagnoses and treatment measures for different patients with diabetics.

  1. Evaluation of Electrolytes Imbalance and Dyslipidemia in Diabetic Patients.

    Science.gov (United States)

    Hasona, Nabil A; Elasbali, Abdulbaset

    2016-04-01

    Electrolytes and Lipids have always played significant roles, and changes in their concentrations gives good indications of disease progression in a number of non-communicable diseases. Diabetes mellitus is the most common metabolic disorder in the community. Diabetics may suffer from electrolyte disorders due to complications of diabetes mellitus and the medication they receive. Serum glucose, electrolytes (Na⁺, K⁺, Cl(-) and Ca(++)), and lipid profiles (total cholesterol, triglyceride, and HDL-c) were determined in 100 diabetics and in non-diabetic subjects. All the diabetic patients had a significant (p electrolytes found in diabetics may have great potential as a diagnostic tool in clinical practice and have a significant effect upon the risk of contracting many diseases.

  2. The PRIDE (Partnership to Improve Diabetes Education) Toolkit: Development and Evaluation of Novel Literacy and Culturally Sensitive Diabetes Education Materials.

    Science.gov (United States)

    Wolff, Kathleen; Chambers, Laura; Bumol, Stefan; White, Richard O; Gregory, Becky Pratt; Davis, Dianne; Rothman, Russell L

    2016-02-01

    Patients with low literacy, low numeracy, and/or linguistic needs can experience challenges understanding diabetes information and applying concepts to their self-management. The authors designed a toolkit of education materials that are sensitive to patients' literacy and numeracy levels, language preferences, and cultural norms and that encourage shared goal setting to improve diabetes self-management and health outcomes. The Partnership to Improve Diabetes Education (PRIDE) toolkit was developed to facilitate diabetes self-management education and support. The PRIDE toolkit includes a comprehensive set of 30 interactive education modules in English and Spanish to support diabetes self-management activities. The toolkit builds upon the authors' previously validated Diabetes Literacy and Numeracy Education Toolkit (DLNET) by adding a focus on shared goal setting, addressing the needs of Spanish-speaking patients, and including a broader range of diabetes management topics. Each PRIDE module was evaluated using the Suitability Assessment of Materials (SAM) instrument to determine the material's cultural appropriateness and its sensitivity to the needs of patients with low literacy and low numeracy. Reading grade level was also assessed using the Automated Readability Index (ARI), Coleman-Liau, Flesch-Kincaid, Fry, and SMOG formulas. The average reading grade level of the materials was 5.3 (SD 1.0), with a mean SAM of 91.2 (SD 5.4). All of the 30 modules received a "superior" score (SAM >70%) when evaluated by 2 independent raters. The PRIDE toolkit modules can be used by all members of a multidisciplinary team to assist patients with low literacy and low numeracy in managing their diabetes. © 2015 The Author(s).

  3. Evaluating the Association between Diabetes, Cognitive Decline and Dementia

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2015-07-01

    Full Text Available The aim of this article is to review the association between diabetes mellitus, cognitive decline and dementia, including the effects of cognitive decline and dementia on self management of diabetes. This is a literature review of primary research articles. A number of contemporary research articles that met the inclusion criteria were selected for this review paper. These articles were selected using a number of search strategies and electronic databases, such as EBSCOhost Research and SwetsWise databases. The duration of diabetes, glycated haemoglobin levels and glycaemic fluctuations were associated with cognitive decline and dementia. Similarly, hypoglycaemia was significantly related to increased risk of developing cognitive decline and dementia. Furthermore, cognitive decline and dementia were associated with poorer diabetes management. There is evidence of the association between diabetes, cognitive decline and dementia including the shared pathogenesis between diabetes and Alzheimer’s disease. In addition, the self management of diabetes is affected by dementia and cognitive decline. It could be suggested that the association between diabetes and dementia is bidirectional with the potential to proceed to a vicious cycle. Further studies are needed in order to fully establish the relationship between diabetes, cognitive decline and dementia. Patients who have diabetes and dementia could benefit from structured education strategies, which should involve empowerment programmes and lifestyle changes. The detection of cognitive decline should highlight the need for education strategies.

  4. Evaluation of Preventive Studies in Type 1 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Müyesser Sayki Arslan

    2013-06-01

    Full Text Available Type 1 diabetes mellitus (DM is a chronic autoimmune disease in which destruction of the beta cells in the islets of Langerhans results in insulin deficiency and hyperglycemia. We only definitely know that autoimmunity is the most important effector mechanism of type 1 DM. Type 1 DM precipitates in genetically susceptible individuals after an exposure to environmental trigger. According to current data, type 1 DM-associated genes are classified as susceptibility and protective genes. This insidious disease process evolves over a period of years. Prevention of type 1 DM requires detection of the earliest events in the process. Until now, autoantibodies are generally used as a serum biomarker, but current studies about T cell and metabolome might strengthen diagnostic view. Current preventive clinical studies usually focus on environmental factors. During the natural course of type 1 DM, many strategies have been tested at different stages in the form of primary, secondary and tertiary studies. The aim of the intervention studies for type 1 diabetes is to suppress pathogenic autoreactivity, restore/preserve beta cell mass and function to sufficient levels to provide good metabolic control, and to delay or prevent disease development. Therapeutic studies evaluate the effect of antigen specific and non-specific immune interventions, restoration of the damaged beta cells and also combination of these therapies. The results of intervention studies done till now are modulation of autoimmune process and partial prevention of loss of insulin release following the diagnosis. A single long-term effective prevention has not been identified yet. Turk Jem 2013; 17: 38-45

  5. Diabetes

    OpenAIRE

    Smith, Paul

    2003-01-01

    Derbyshire general practitioner Stuart Bootle has had diabetes for 20 years. He speaks to Paul Smith, who has type 1 diabetes himself, about the trials and tribulations of being on the receiving end of NHS care

  6. Evaluation of anti-diabetic activity of Glucova Active Tablet on Type I and Type II diabetic model in rats.

    Science.gov (United States)

    Soni, Hardik; Patel, Sejal; Patel, Ghanshyam; Paranjape, Archana

    2014-04-01

    Glucova Active Tablet is a proprietary Ayurvedic formulation with ingredients reported for anti-hyperglycemic, anti-hyperlipidemic activity and antioxidant properties. Evaluation of anti-diabetic activity of Glucova Active Tablet on Type I and Type II diabetic model in rats. Experimental Type I diabetes was induced in 24 albino rats with intra-peritoneal injection of streptozotocin (50 mg/kg). Type II diabetes was induced in 18 albino rats by intra-peritoneal injection of streptozotocin (35 mg/kg) along with high fat diet. The rats were divided in 5 groups for Type I model and 4 groups for Type II model. Normal control group was kept common for both experimental models. Glucova Active Tablet (108 mg/kg) treatment was provided for 28 days twice daily orally. Fasting blood glucose level, serum lipid profile and liver anti-oxidant parameters like superoxide dismutase and reduced glutathione was carried out in both experimental models. Pancreas histopathology was also done. Statistical analysis were done by 'analysis of variance' test followed by post hoc Tukey's test, with significant level of P anti-diabetic activity in Type I and Type II diabetic rats. It was also found showing good anti-hyperlipidemic activity and anti-oxidant property.

  7. Evaluation of selective screening for diagnosis of gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Garshasbi A

    2009-07-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Gestational diabetes mellitus is diagnosed as carbohydrate in tolerance demonstrated for the first time in the course of pregnancy. The aim of this study was to evaluate the selective screening method for gestational diabetes mellitus (GDM based on: 1- recommendation of the fourth workshop- conference on GDM 2- evaluation of risk factors"n"n Methods: A case- control study was performed on 370 pregnancies inflicted by GDM in Hazrat Zaynab Hospital, Shahed University. The maternal and perinatal outcomes and prevalence of risk factors based on recommendation of the fourth workshop- conference on GDM in these women with GDM were compared with the same data and risk factors of randomly selected 600 pregnant women at the same time and in the same hospital, they all underwent universal testing for GDM, and their OGTT were normal. "n"n Results: The prevalence of all risk factors was significantly higher in the group with GDM, but 45 of these women (12% had no risk factors. 107 women (29% with GDM were at low risk and would remain undiagnosed if selective screening method was used. The main neonatal complications in the low- risk group did not differ from the complications in other

  8. Evaluation of diabetes determinants in woolly monkeys (Lagothrix lagotricha)

    NARCIS (Netherlands)

    Ange-van Heugten, K.D.; Burns, R.; Verstegen, M.W.A.; Jansen, W.L.; Ferket, P.R.; Heugten, E.

    2007-01-01

    Woolly monkeys (Lagothrix lagotricha) are a threatened specie in the wild with limited successful management in captivity due to diagnosed hypertension and suspected diabetic conditions. Six woolly monkeys with known hypertension problems were tested to determine if diabetes mellitus and current

  9. Evaluation of Adherence to Diabetic Treatment in Northern Region ...

    African Journals Online (AJOL)

    Purpose: To determine medication adherence and predictors of suboptimal adherence in patients with diabetes type 2, and to address the factors that are associated with treatment non-adherence in Northern Region of United Arab Emirates (UAE). Methods: This cross-sectional study involved 200 type 2 diabetes mellitus ...

  10. [Evaluation of diabetic microangiopathy using optical coherence tomography angiography].

    Science.gov (United States)

    Czakó, Cecília; Sándor, Gábor László; Ecsedy, Mónika; Szepessy, Zsuzsanna; Borbándy, Ágnes; Resch, Miklós; Papp, András; Récsán, Zsuzsa; Horváth, Hajnalka; Nagy, Zoltán Zsolt; Kovács, Illés

    2018-02-01

    Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA 1c , dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (pdiabetes duration (pdiabetic retinopathy compared to control subjects (pdiabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320-326.

  11. Evaluation of essential trace metals in female type 2 diabetes ...

    African Journals Online (AJOL)

    Diabetes mellitus (DM) has been reported to be associated with derangement of micronutrients. This study was to investigate the plasma levels of antioxidant elements (zinc, selenium, copper) haemopoeitic elements (chromium and iron) and magnesium in female type 2 diabetes mellitus (DM) patients. Fifty (50) female type ...

  12. Evaluation of Smoking Status among Diabetes Patients in the State ...

    African Journals Online (AJOL)

    Purpose: To determine the prevalence of smoking among diabetes patients attending Diabetes Outpatient Clinic at Penang General Hospital, Penang, Malaysia. Methods: A cross-sectional study was undertaken to assess the smoking status of all the patients that registered at the above clinic. The data were extracted from ...

  13. Evaluation of liver marker enzymes in diabetic subjects in the ...

    African Journals Online (AJOL)

    The activity levels of the liver marker enzymes; Aspartate and Alanine amino transferases (AST and ALT), Alkaline Phosphatase (ALP) and Gamma glutamyltransferase (GGT) in diabetic and non-diabetic subjects within the ages of 25 to 86 were assayed. This study was for two weeks. The results indicated that the plasma ...

  14. Evaluation of Punica granatum Peel Against Diabetic Wound Infection

    African Journals Online (AJOL)

    Background: Foot infections are a common and serious problem in diabetic patients. Objectives: To investigate the antibacterial activity of some medicinal plants used by traditional healers for diabetic wounds and to examine in-vivo wound healing activity of active extracts. Materials and Methods: An experimental study in ...

  15. Home care in childhood diabetes : a controlled evaluation study

    NARCIS (Netherlands)

    M.W. Zoeteweij (Moniek)

    1992-01-01

    textabstractThis thesis considers children with insulin-dependent diabetes mellitus and their psychological and medical functioning during 31 months of participation in a home-care program compared to traditional hospital-based care. In general, diabetes mellitus -derived from the greek diabainein

  16. Evaluation of Corneal Endothelium in Children and Adolescents with Type 1 Diabetes Mellitus

    OpenAIRE

    Urban, Beata; Raczyńska, Dorota; Bakunowicz-Łazarczyk, Alina; Raczyńska, Krystyna; Krętowska, Małgorzata

    2013-01-01

    Purpose. To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. Materials and Methods. The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the ...

  17. Evaluation of corneal endothelium in children and adolescents with type 1 diabetes mellitus.

    Science.gov (United States)

    Urban, Beata; Raczyńska, Dorota; Bakunowicz-Łazarczyk, Alina; Raczyńska, Krystyna; Krętowska, Małgorzata

    2013-01-01

    To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the control group. The mean duration of diabetes was 8.02 ± 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P. The mean ECD in diabetic eyes was 2435.55 ± 443.43 cells/mm(2) and was significantly lower than in control group (2970.75 ± 270.1 cells/mm(2)). The mean CCT was 0.55 ± 0.03 mm in diabetic group versus 0.53 ± 0.033 mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level. ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT.

  18. Evaluation of Corneal Endothelium in Children and Adolescents with Type 1 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Beata Urban

    2013-01-01

    Full Text Available Purpose. To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. Materials and Methods. The endothelial cell density (ECD and central corneal thickness (CCT were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the control group. The mean duration of diabetes was 8.02 ± 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P. Results. The mean ECD in diabetic eyes was 2435.55 ± 443.43 cells/mm2 and was significantly lower than in control group (2970.75 ± 270.1 cells/mm2. The mean CCT was 0.55 ± 0.03 mm in diabetic group versus 0.53 ± 0.033 mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level. Conclusions. ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT.

  19. Neurofunctional evaluation of young male offspring of rat dams with diabetes induced by streptozotocin.

    Science.gov (United States)

    Delascio Lopes, Carla; Sinigaglia-Coimbra, Rita; Mazzola, Jacqueline; Camano, Luiz; Mattar, Rosiane

    2011-01-01

    Diabetes mellitus (DM) is a complex disease, being one of the most prevalent diseases worldwide. As a consequence, pregnancy-associated diabetes is increasingly common. Given the numerous studies about the influence of diabetes on offspring of diabetic rat dams, the neurological outcome is of outmost importance. This paper aimed at evaluating the neurofunctional performance of young male offspring of rat dams with diabetes induced by streptozotocin. Diabetes was induced in Wistar female rats by streptozotocin administration, while control groups received vehicle injection. At two-month survival period, male offspring from each group were randomized to the water maze Morris test, in order to assess their neurofunctional status. There was no significant difference between the groups as assessed by the Morris water maze test for spatial reference task. Our results point to the need of further investigation on the offspring neurofunctional performance.

  20. Neurofunctional Evaluation of Young Male Offspring of Rat Dams with Diabetes Induced by Streptozotocin

    Science.gov (United States)

    Delascio Lopes, Carla; Sinigaglia-Coimbra, Rita; Mazzola, Jacqueline; Camano, Luiz; Mattar, Rosiane

    2011-01-01

    Diabetes mellitus (DM) is a complex disease, being one of the most prevalent diseases worldwide. As a consequence, pregnancy-associated diabetes is increasingly common. Given the numerous studies about the influence of diabetes on offspring of diabetic rat dams, the neurological outcome is of outmost importance. This paper aimed at evaluating the neurofunctional performance of young male offspring of rat dams with diabetes induced by streptozotocin. Diabetes was induced in Wistar female rats by streptozotocin administration, while control groups received vehicle injection. At two-month survival period, male offspring from each group were randomized to the water maze Morris test, in order to assess their neurofunctional status. There was no significant difference between the groups as assessed by the Morris water maze test for spatial reference task. Our results point to the need of further investigation on the offspring neurofunctional performance. PMID:22363880

  1. Evaluation of current trends and recent development in insulin therapy for management of diabetes mellitus.

    Science.gov (United States)

    Nawaz, Muhammad Sarfraz; Shah, Kifayat Ullah; Khan, Tahir Mehmood; Rehman, Asim Ur; Rashid, Haroon Ur; Mahmood, Sajid; Khan, Shahzeb; Farrukh, Muhammad Junaid

    2017-12-01

    Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus. The paramount parameters of the selected studies include the insulin type & its dose, type of diabetes, duration and comparison of different insulin protocols. In addition, various newly developed approaches for insulin delivery with potential output have also been evaluated. A great variability was observed in managing diabetes mellitus through insulin therapy and the important controlling factors found for this therapy include; dose titration, duration of insulin use, type of insulin used and combination therapy of different insulin. A range of research articles on current trends and recent advances in insulin has been summarized, which led us to the conclusion that multiple daily insulin injections or continuous subcutaneous insulin infusion (insulin pump) is the best method to manage diabetes mellitus. In future perspectives, development of the oral and inhalant insulin would be a tremendous breakthrough in Insulin therapy. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  2. Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

    Science.gov (United States)

    Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

    2011-05-01

    Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (diabetes disease management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012.

    Science.gov (United States)

    Rickels, Michael R; Bellin, Melena; Toledo, Frederico G S; Robertson, R Paul; Andersen, Dana K; Chari, Suresh T; Brand, Randall; Frulloni, Luca; Anderson, Michelle A; Whitcomb, David C

    2013-01-01

    Diabetes and glucose intolerance are common complications of chronic pancreatitis, yet clinical guidance on their detection, classification, and management is lacking. A working group reviewed the medical problems, diagnostic methods, and treatment options for chronic pancreatitis-associated diabetes for a consensus meeting at PancreasFest 2012. Guidance Statement 1.1: Diabetes mellitus is common in chronic pancreatitis. While any patient with chronic pancreatitis should be monitored for development of diabetes, those with long-standing duration of disease, prior partial pancreatectomy, and early onset of calcific disease may be at higher risk. Those patients developing diabetes mellitus are likely to have co-existing pancreatic exocrine insufficiency. Guidance Statement 1.2: Diabetes occurring secondary to chronic pancreatitis should be recognized as pancreatogenic diabetes (type 3c diabetes). Guidance Statement 2.1: The initial evaluation should include fasting glucose and HbA1c. These tests should be repeated annually. Impairment in either fasting glucose or HbA1c requires further evaluation. Guidance Statement 2.2: Impairment in either fasting glucose or HbA1c should be further evaluated by a standard 75 g oral glucose tolerance test. Guidance Statement 2.3: An absent pancreatic polypeptide response to mixed-nutrient ingestion is a specific indicator of type 3c diabetes. Guidance Statement 2.4: Assessment of pancreatic endocrine reserve, and importantly that of functional beta-cell mass, should be performed as part of the evaluation and follow-up for total pancreatectomy with islet autotransplantation (TPIAT). Guidance Statement 3: Patients with pancreatic diabetes shall be treated with specifically tailored medical nutrition and pharmacologic therapies. Physicians should evaluate and treat glucose intolerance in patients with pancreatitis. Copyright © 2013 IAP and EPC. All rights reserved.

  4. Transformation of the multidisciplinary diabetic foot clinic into a multidisciplinary diabetic foot day unit: results from a service evaluation.

    Science.gov (United States)

    Manu, Chris A; Mustafa, Omar G; Bates, Maureen; Vivian, Gill; Mulholland, Nicola; Elias, David; Huang, Dean Y; Deane, Colin; Cavale, Naveen; Kavarthapu, Venu; Rashid, Hisham; Edmonds, Michael

    2014-09-01

    The natural history of the diabetic foot is aggressive and complex. To counteract this, we describe the transformation of a Multidisciplinary Diabetic Foot Clinic into a Multidisciplinary Diabetic Foot Day Unit, which delivers an emergency open access system for patients, with a "one-stop," same day service in which investigations are performed, results reviewed and treatment implemented. It also provides joint clinics with vascular, orthopaedic, and plastic surgeons and specialized clinics for casting of complex neuropathic feet and for the administration of intravenous or intramuscular antibiotics on the same day. The aim was to document these increasingly wide-ranging facilities by undertaking a retrospective evaluation over a 6-week period, with analysis of notes, investigations, and an anonymous patient satisfaction survey. The clinic was visited by 597 patients who attended in 1076 appointments, of which 112 (10.4%) were emergency visits; these patients attended the clinic without a booked appointment but via an open access policy, 93 of whom were known to the clinic, but 19 were new self-referred patients to the service. Furthermore, 197 (18%) were seen in a Joint Vascular Diabetic Foot Clinic and 98 (9%) were seen in a Joint Orthopaedic Plastic Diabetic Foot Clinic, 570 (53%) were seen in an Active Ulcer Clinic and 97 (9%) in a Total Contact Casting Clinic. Forty-five percent of patients were prescribed antibiotics, including 188 (76%) as oral and 45(18%) as intravenous antibiotics and 15(6%) as intramuscular injections. Of the 1076 appointments, 150 (14%) patients were in the foot clinic for more than 4 hours. Sixty (10%) patients were reviewed 4 or more times over the 6-week period. Only 22 (2%) were admitted to hospital. Of the 125 survey responders, 98% were satisfied with this service, which has evolved from a Diabetic Foot Clinic into a Multidisciplinary Diabetic Foot Day Unit. © The Author(s) 2014.

  5. Evaluation of electrocardiographic parameters in patients with diabetes insipidus.

    Science.gov (United States)

    Deniz, Ferhat; Kepez, Alper; Ay, Seyit Ahmet; Ergogan, Okan; Baskoy, Kamil; Guncıkan, Mustafa Nuri; Dogan, Zekeriya; Yonem, Arif

    2015-11-01

    There is limited data regarding the effect of altered serum osmolality on cardiac electrical activity. The aim of the present study is to evaluate the electrocardiographic (ECG) effects of diabetes insipidus (DI) and any related hyperosmolality in a population of young patients with DI and without any known cardiovascular disease or risk factors. Twelve-lead ECG's of 44 consecutive untreated young male patients (age: 21.8 ± 2.9 years) who had been referred to endocrinology clinic and diagnosed as DI based on water deprivation test were retrospectively evaluated. A total of 30 age-matched (21.9 ± 2.4 years) healthy males were selected as control group and ECG's of these controls were obtained for comparison with ECG's of DI patients. All ECG parameters were measured and compared. Duration of QRS complex was significantly shorter in patients with DI compared with controls (85.2 ± 12.0 vs. 94.0 ± 10.6 ms, p: 0.001). P wave dispersion (PWD) of patients with DI was significantly higher compared with controls (31.9 ± 9.9 vs. 26.5 ± 10.6 ms, p: 0.03) and it was significantly correlated with serum osmolality and serum sodium level (r = - 0.36, p: 0.02 and r: - 0.35, p: 0.02, respectively). DI patients without any cardiovascular disease or risk factors displayed significantly shorter QRS duration and increased p wave dispersion compared with controls.

  6. Evaluation of anti-diabetic activity of glycyrrhizin-loaded nanoparticles in nicotinamide-streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Rani, Ruma; Dahiya, Shakti; Dhingra, Dinesh; Dilbaghi, Neeraj; Kim, Ki-Hyun; Kumar, Sandeep

    2017-08-30

    Glycyrrhizin is an active constituent of the roots and rhizomes of Glycyrrhiza glabra and has anti-hyperglycemic effects. In this study, nanoparticles (NPs) loaded with glycyrrhizin or metformin were evaluated in vivo for their anti-hyperglycemic potency towards type-II diabetes in rats. The NPs were produced via the ionotropic gelation method using the biocompatible polymers chitosan and gum arabic. The polymer concentration was optimized using the 32 factorial method to acquire both minimum particle size and maximum encapsulation efficiency. The NPs were then characterized with respect to particle size, encapsulation efficiency, stability, chemical interactions, and in vitro drug dissolution profiles using spectroscopic and microscopic analysis. Furthermore, glycyrrhizin and metformin and their nanoformulations were administered for 21 successive days to diabetic rats. Glycyrrhizin-loaded NPs had significant anti-diabetic effects even though they contained approximately one quarter of the dosage relative to the pure form. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Impact of Migration and Acculturation on Prevalence of Type 2 Diabetes and Related Eye Complications in Indians Living in a Newly Urbanised Society

    OpenAIRE

    Zheng, Yingfeng; Lamoureux, Ecosse L.; Ikram, M. Kamran; Mitchell, Paul; Wang, Jie Jin; Younan, Christine; Anuar, Ainur Rahman; Tai, E-Shyong; Wong, Tien Y.

    2012-01-01

    textabstractBackground: Health of migrants is a major public health challenge faced by governments and policy makers. Asian Indians are among the fastest growing migration groups across Asia and the world, but the impact of migration and acculturation on diabetes and diabetes-related eye complications among Indians living in urban Asia remains unclear. Methodologies/Principal Findings: We evaluated the influence of migration and acculturation (i.e., migration status and length of residence) o...

  8. Predictors of cardiac morbidity in diabetic, new-onset diabetic and non-diabetic high-risk hypertensive patients: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial.

    Science.gov (United States)

    Aksnes, Tonje A; Kjeldsen, Sverre E; Rostrup, Morten; Holzhauer, Björn; Hua, Tsushung A; Julius, Stevo

    2016-08-01

    Diabetic and new-onset diabetic patients with hypertension have higher cardiac morbidity than patients without diabetes. We aimed to investigate whether baseline predictors of cardiac morbidity, the major constituent of the primary endpoint in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, were different in patients with diabetes and new-onset diabetes compared to patients without diabetes. In total, 15,245 high-risk hypertensive patients in the VALUE trial were followed for an average of 4.2 years. At baseline, 5250 patients were diabetic by the 1999 World Health Organization criteria, 1298 patients developed new-onset diabetes and 8697 patients stayed non-diabetic during follow-up. Cardiac morbidity was defined as a composite of myocardial infarction and heart failure requiring hospitalization, and baseline predictors were identified by univariate and multivariate stepwise Cox regression analyses. History of coronary heart disease (CHD) and age were the most important predictors of cardiac morbidity in both diabetic and non-diabetic patients. History of CHD, history of stroke and age were the only significant predictors of cardiac morbidity in patients with new-onset diabetes. Predictors of cardiac morbidity, in particular history of CHD and age, were essentially the same in high-risk hypertensive patients with diabetes, new-onset diabetes and without diabetes who participated in the VALUE trial.

  9. Evaluation of anti-diabetic effects of hydroalcoholic extract of green tea and cinnamon on streptozotocin-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    Ghasem Shokri

    2015-06-01

    Full Text Available Today diabetes is one of the most common diseases in the world that affects half of the world population. The use of medicinal herbs especially green tea and cinnamon has been taken into consideration for relieving the symptoms of diabetes, but there were some different ideas about their effectiveness. So, this study was conducted to evaluate the effect of cinnamon and green tea extract, individually and in combination, on blood glucose and weight loss in diabetic mice with Streptozotocin (STZ. The experiment was performed on 50 Wistar rats.  A total of 50 rats were divided into 10 groups of 5 and STZ was injected at the dose of 40 mg/kg/day for 5 days intraperitoneally. After diabetes induction, three groups received, 50, 100 and 200 mg doses of green tea extract,  three groups received 50, 100 and 200 mg doses of cinnamon extract  and three final groups received 50, 100 and 200 mg doses of  cinnamon  and green tea in combination by gavages daily for 6 weeks. After each period of treatments, blood glucose and the weight of animals were determined. At the end of the sixth week, blood glucose and weight loss were improved in diabetic rats in a dose-dependent manner and the dose of 200 mg/kg extract cinnamon with green tea had the most appropriate synergic effect.

  10. Evaluation of Cardioprotective Effects of Genistein against Diabetes ...

    African Journals Online (AJOL)

    Keywords: Cardiac dysfunction, Genistein, Oxidative stress, Inflammatory response, Insulin resistance,. Glucose tolerance. Tropical Journal of ... most prevalent cardiovascular complications of diabetes, characterized by both systolic and ... emerging experimental data suggest that cardiac insulin resistance and metabolic ...

  11. Southeast Asia

    Science.gov (United States)

    2002-01-01

    Home to beautiful jungles, booming industry, and age-old temples, Southeast Asia has become a confluence of ancient and modern life. This true-color image of mainland Southeast Asia was acquired on November 30, 2001, by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra spacecraft. The body of water in the upper righthand corner of the image is the Gulf of Tonkin. East and southeast of the gulf are the dark green jungles of Vietnam, Laos, and Cambodia. The light brown Mekong River winds its way through the center of the Cambodian jungle and into southern Vietnam. The dark blue patch to the left of the river at the bottom of the image is the Tonle Sap. Literally translated to mean 'Great Lake,' the Tonle Sap is the largest freshwater lake in Southeast Asia. During the rainy season from May to October, the lake will more than double in size growing from its wintertime extent of 3,000 square kilometers to over 7,500 square kilometers. North of the lake, approximately in the center of the image, is a saucer-shaped patch of reddish brown land known as the Khorat Plateau. Situated 90 to 200 meters above sea level in eastern Thailand, the dry plateau is mostly covered with farmland and savanna-type grasses and shrubs. Moving south again, the large body of light blue water at the bottom central portion of the image is the Gulf of Thailand. By switching to the full resolution image (250 meters per pixel) and following the Gulf of Thailand to its northernmost extent, one can see a pinkish beige patch of terrain covered by a faint latticework of fine lines. These are likely to be the network of roads that crisscross Bangkok and its surrounding suburbs and fertile farmland. The narrow strip of land to the east of the Gulf of Thailand is the Malay Peninsula. The body of water to the left of the peninsula is the Gulf of Martaban, which borders Myanmar (Burma). At the far upper lefthand corner of the image, the water has turned light brown from

  12. Evaluación periodontal de pacientes portadores de diabetes mellitus Periodontal evaluation of patients with diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Carlos Rogério Ribeiro Fontanini

    2006-08-01

    Full Text Available Los portadores de diabetes mellitus presentan manifestaciones sistémicas que pueden interferir en la atención odontológica. El riesgo de periodontitis aumenta cuando el paciente está descompensado metabólicamente. El objetivo de nuestra investigación fue evaluar las condiciones periodontales relacionadas en pacientes con diabetes mellitus. Se examinaron 57 pacientes portadores de diabetes. Las condiciones periodontales fueron evaluadas por el índice CPITN. Se constató un inadecuado control metabólico, pues 38 pacientes (66,67 % se encontraban con niveles glicémicos alterados. Se evaluaron en total 342 sextantes y 49 fueron considerados válidos para examen. Los códigos 0 y 1 estuvieron representados por un paciente cada uno; el código 2 fue observado en 11 sextantes examinados; el código 3 en 18 y el código 4 en 22 de estos. Concluimos que la enfermedad periodontal es muy severa en diabéticos. En función de las manifestaciones bucales encontradas en esos pacientes, podemos sugerir que individuos portadores de diabetes mellitus representan un grupo especial que requiere medidas odontológicas preventivas y terapéuticas específicas.Diabetes mellitus carriers show systemic manifestations that may interfere with odontological care. The risk of periodontitis increases with metabolic decompensation of a patient. The objective of our research work was to evaluate the periodontal condition in patients with diabetes mellitus. Fifty seven diabetic patients were examined. CPITN index served to assess the periodontal conditions. It was established that metabolic control was inadequate since 38 patients (66,67% presented with altered glycemic levels. Three hundred and forty two sextants were assessed, 49 of which were considered valid for test. Codes 0 and 1 were represented by one patient each; code 2 was observed in 11 analyzed sextants; code 3 in 18 and code 4 in 22. We concluded that periodontal disease is very severe in diabetics

  13. Current and future economic burden of diabetes among working-age adults in Asia: conservative estimates for Singapore from 2010-2050.

    Science.gov (United States)

    Png, May Ee; Yoong, Joanne; Phan, Thao Phuong; Wee, Hwee Lin

    2016-02-16

    Diabetes not only imposes a huge health burden but also a large economic burden worldwide. In the working-age population, cost of lost productivity can far exceed diabetes-related medical cost. In this study, we aimed to estimate the current and future indirect and excess direct costs of diagnosed type 2 diabetes among the working-age population in Singapore. A previously-published epidemiological model of diabetes was adapted to forecast prevalence among working-age patients with diagnosed type 2 diabetes in the absence of interventions. The current methodology of the American Diabetes Association was adopted to estimate the costs of diabetes for this population. Diabetes-related excess direct medical costs were obtained from a local cost study while indirect costs were calculated using the human capital approach applied to local labor force statistics. These cost were estimated conservatively from a societal perspective on a per patient basis and projected to the overall Singapore population from 2010 to 2050. In 2010, total economic costs per working-age patient were estimated to be US$5,646 (US$4,432-US$10,612), of which 42% were excess direct medical costs and 58% indirect productivity-related losses. Total cost is projected to rise to US$7,791 (US$5,741-US$12,756) in 2050, with the share of indirect costs rising to 65%. Simultaneous increases in prevalence imply that the total economic costs of diabetes for the entire working-age population will increase by 2.4 fold from US$787 million in 2010 to US$1,867 million in 2050. By current projections, diabetes in Singapore represents a growing economic burden. Among the working-age population, the impact of productivity loss will become increasingly significant. Prevention efforts to reduce overall prevalence should also engage stakeholders outside the health sector who ultimately bear the indirect burden of disease.

  14. Human Capital Index Rankings 2013 for Asia and Pacific Countries and Evaluation of Human Capital Indicators for Pakistan

    OpenAIRE

    Muhammad Bashir

    2013-01-01

    This paper presents Human Capital Index Rankings for 20 Asia and Pacific Countries. The Human Capital Index (HCI) developed by the (World Economic Forum) assesses 122 countries, representing over 90% of the world’s population. The Human Capital Index (HCI) measures the countries on their ability to develop and deploy healthy, educated and able workers through 4 pillars: education, health & wellness, workforce & employment and enabling environment. The Index consists of 51 indicators in total,...

  15. Evaluation of anti-diabetic activity of Glucova Active Tablet on Type I and Type II diabetic model in rats

    Directory of Open Access Journals (Sweden)

    Hardik Soni

    2014-01-01

    Full Text Available Background: Glucova Active Tablet is a proprietary Ayurvedic formulation with ingredients reported for anti-hyperglycemic, anti-hyperlipidemic activity and antioxidant properties. Objective: Evaluation of anti-diabetic activity of Glucova Active Tablet on Type I and Type II diabetic model in rats. Materials and Methods: Experimental Type I diabetes was induced in 24 albino rats with intra-peritoneal injection of streptozotocin (50 mg/kg. Type II diabetes was induced in 18 albino rats by intra-peritoneal injection of streptozotocin (35 mg/kg along with high fat diet. The rats were divided in 5 groups for Type I model and 4 groups for Type II model. Normal control group was kept common for both experimental models. Glucova Active Tablet (108 mg/kg treatment was provided for 28 days twice daily orally. Fasting blood glucose level, serum lipid profile and liver anti-oxidant parameters like superoxide dismutase and reduced glutathione was carried out in both experimental models. Pancreas histopathology was also done. Statistical analysis were done by ′analysis of variance′ test followed by post hoc Tukey′s test, with significant level of P < 0.05.Results and Discussion: Glucova Active Tablet showed significant effect on fasting blood glucose level. It also showed significant alteration in lipid profile and antioxidant parameters. Histopathology study revealed restoration of beta cells in pancreas in Glucova Active Tablet treated group. Conclusion: Finding of this study concludes that Glucova Active Tablet has shown promising anti-diabetic activity in Type I and Type II diabetic rats. It was also found showing good anti-hyperlipidemic activity and anti-oxidant property.

  16. Clinical evaluation of Ginkgo biloba extract for diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Cheng-Yi Zhu

    2016-02-01

    Full Text Available AIM:To evaluate the clinical efficacy of Ginkgo biloba extract(GBEfor the patients with mild or moderate non-proliferative diabetic retinopathy(NPDR. METHODS: Randomized controlled study. A total of 80 patients(150 eyeswith mild or moderate NPDR were divided into two groups: the control group(39 patients with 72 eyesand the treatment group(41 patients with 78 eyes. Patients in the control group were given 100mg enteric-coated aspirin tablets, orally, once per day. Based on the above treatment, the treated group was added with GBT 2mL, orally, three times per day. Patients were followed up for 6mo, and the overall curative effect, visual acuity, visual field mean defect, the result of fundus fluorescein angiography, serum lipid levels, platelet aggregation rate and platelet adhesion rate were measured and evaluated. RESULTS: After treatments, the total effective rate in the treatment group was 75.6% and significantly higher than that(58.7%in the control group(Z=2.6002, P=0.0047. Compared with the control group, the treatment group was found to have higher visual acuity and less visual field mean defect significantly(t=-2.01,P=0.0477; t=4.06,P=0.0001; the numbers of retinal micro-aneurysms and areas of retinal hemorrhage significantly decreased(t=7.86,Pt=3.13,P=0.0024; the serum total cholesterol, triglycerides, low-density lipoprotein cholesterol in treatment group significantly decreased, the high-density lipoprotein cholesterol increased(t=2.25,P=0.0270; t=3.41,P=0.0010; t=3.34,P=0.0013; t=3.76,P=0.0003; t=-3.30,P=0.0014; platelet aggregation rate and platelet adhesion rate were significantly lower(t=4.31,Pt=4.93,PCONCLUSION: The results show that GBT for treatment of mild and moderate NPDR has a definite effect.

  17. Evaluation of Chromosomal Instability in Diabetic Rats Treated with Naringin

    Directory of Open Access Journals (Sweden)

    Saleh A. Bakheet

    2011-01-01

    Full Text Available We used the bone marrow DNA strand breaks, micronucleus formations, spermatocyte chromosomal aberrations, and sperm characteristic assays to investigate the chromosomal instability in somatic and germinal cells of diabetic rats treated with multiple doses of naringin. The obtained results revealed that naringin was neither cytotoxic nor genotoxic for the rats at all tested doses. Moreover, naringin significantly reduced the diabetes-induced chromosomal instability in somatic and germinal cells in a dose-dependent manner. In addition, diabetes induced marked biochemical alterations characteristic of oxidative stress including enhanced lipid peroxidation, accumulation of oxidized glutathione, reduction in reduced glutathione, and accumulation of intracellular reactive oxygen species. Treatment with naringin ameliorated these biochemical markers dose-dependently. In conclusion, naringin confers an appealing protective effect against diabetes-induced chromosomal instability towards rat somatic and germinal cells which might be explained partially via diminishing the de novo free radical generation induced by hyperglycemia. Thus, naringin might be a good candidate to reduce genotoxic risk associated with hyperglycemia and may provide decreases in the development of secondary malignancy and abnormal reproductive outcomes risks, which seems especially important for diabetic patients.

  18. Evaluation of Salivary Nitric Oxide and Epidermal Growth Factor in Diabetic Patients and Healthy Group

    Directory of Open Access Journals (Sweden)

    Hamid Reza Abdolsamadi

    Full Text Available Introduction: Nitric oxide (NO and epidermal growth factor (EGF play an important role in biologic systems. The aim of the present study was to evaluate salivary NO and EGF levels changes in type I and II diabetes mellitus comparing to the control group. Materials & Methods: In this cross-sectional study, five ml, saliva of 20 patients with type 1 diabetes mellitus and five ml saliva of 20 patients with type 2 diabetes mellitus attended to Hamadan diabetes research center as well as 20 healthy individuals matched according to age and sex, were collected. NO and EGF were assessed via Griess reaction and Immunoassay methods respectively. Data were analyzed by t-test and Mann-Whitney test.Results: Compared to the control group, the level of NO was increased in patients with type I diabetes (P=0.037, while it did not significantly increase in type II diabetes (P=0.058. The level of EGF in diabetic patients was significantly higher than the control group. There was no significant difference between the salivary level of EGF and NO of patient with type 1 and type 2 mellitus diabetes (P>0.05. The correlation coefficient between NO and EGF levels in type II diabetic patients was -0.278 (P=0.0235. The level of NO and EGF was significantly related to fasting blood sugar and HbA1c (P=0.001.Conclusion: The level of salivary NO in type I diabetes and EGF in type I and II diabetes was higher compared to those of healthy individuals and was related to the severity of the disease.

  19. An evaluation of diabetes targeted apps for Android smartphone in relation to behaviour change techniques.

    Science.gov (United States)

    Hoppe, C D; Cade, J E; Carter, M

    2017-06-01

    Mobile applications (apps) could support diabetes management through dietary, weight and blood glucose self-monitoring, as well as by promoting behaviour change. The present study aimed to evaluate diabetes apps for content, functions and behaviour change techniques (BCTs). Diabetes self-management apps for Android smartphones were searched for on the Google Play Store. Ten apps each from the following search terms were included; 'diabetes', 'diabetes type 1', 'diabetes type 2', 'gestational diabetes'. Apps were evaluated by being scored according to their number of functions and BCTs, price, and user rating. The mean (SD) number of functions was 8.9 (5.9) out of a possible maximum of 27. Furthermore, the mean (SD) number of BCTs was 4.4 (2.6) out of a possible maximum of 26. Apps with optimum BCT had significantly more functions [13.8; 95% confidence interval (CI) = 11.9-15.9] than apps that did not (4.7; 95% CI = 3.2-6.2; P < 0.01) and significantly more BCTs (5.8; 95% CI = 4.8-7.0) than apps without (3.1; 95% CI = 2.2-4.1; P < 0.01). Additionally, apps with optimum BCT also cost more than other apps. In the adjusted models, highly rated apps had an average of 4.8 (95% CI = 0.9-8.7; P = 0.02) more functions than lower rated apps. 'Diabetes apps' include few functions or BCTs compared to the maximum score possible. Apps with optimum BCTs could indicate higher quality. App developers should consider including both specific functions and BCTs in 'diabetes apps' to make them more helpful. More research is needed to understand the components of an effective app for people with diabetes. © 2016 The British Dietetic Association Ltd.

  20. Evaluation of knowledge, Attitude and Practice between Periodontal Disease and Diabetes

    Directory of Open Access Journals (Sweden)

    Fazele Atarbashi Moghadam

    2013-07-01

    Full Text Available Introduction: The importance of the periodontal health maintenance and promotion in diabetes mellitus has been supported. Evidence showed that many patients are unaware about effects of diabetes mellitus on oral health. The aim of this study is to evaluate knowledge, attitudes and practice of diabetic patients concerning the risk of periodontal disease and prevention. Materials and Methods: In this cross sectional study, 156 diabetic patients referring to Yazd Diabetic Research Center were recruited by random selection. Patients completed questionnaires, which included 29 questions about their knowledge, attitude and practice of oral health in diabetes mellitus. The data was scored and analyzed. Result: The results showed knowledge (58.64 and attitude (46.86 scores of diabetic patients were moderate, while their practice (24.3 score were poor. There is statistical significant relation between mean scores of knowledge, attitude and practice of patients with their educational level and age. Conclusion: This study showed knowledge, attitude and practice level of diabetic patients were insufficient on oral health care.

  1. Evaluation of Life Quality Functions in Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Müge Şengül

    2008-01-01

    Full Text Available Objective: In this study, we aimed to investigate the effect of glycemic regulation, duration of diabetes and antidiabetic treatment on the quality of life (QOL and to detect other factors that may affect QOL in type 2 diabetic patients using the short form-36 quality of life scale (SF-36. Materials and Methods: One hundred patients diagnosed with type 2 diabetes (according to the American Diabetes Association criteria upon admission to the Endocrinology clinic of Adana Numune Training and Research Hospital between 1 July 2007 and 31 October 2007 were included in the study. One hundred healthy age- and gender-matched cases were also included as a control group. QOL assessments were made using the SF-36, and blood and urine samples were also collected. Results: In this study, we found several factors that affect QOL parameters. We detected a specific impairment in QOL among diabetic patients compared to healthy control subjects. The presence of more complications, neuropathy, retinopathy, low education level, lack of diabetes education, insulin treatment, inadequate metabolic control, long duration of disease, concomitant chronic disease and being a woman were all additional factors found to negatively affect the QOL. Conclusions: While our results mostly support the current literature, we believe that physiologic, demographic, and behaviour/attitude characteristics should be evaluated together with diabetic complications. Therefore, along with achieving metabolic control, attempts to identify risky patients are gaining importance as a way to improve the QOL of patients with type 2 diabetes. Turk Jem 2008; 12: 68-72

  2. Diabetes

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth R

    2015-01-01

    For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestat......For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women...... with gestational diabetes mellitus is highly relevant....

  3. Design and Usability Evaluation of Social Mobile Diabetes Management System in the Gulf Region.

    Science.gov (United States)

    Alanzi, Turki; Istepanian, Robert; Philip, Nada

    2016-09-26

    The prevalence of diabetes in the Gulf States is one of the highest globally. It is estimated that 20% of the population in the region has been diagnosed with diabetes and according to the International Diabetes Federation (IDF), five of the IDF's "top 10" countries for diabetes prevalence in 2011 and projected for 2030 are in this region. In recent years, there have been an increasing number of clinical studies advocating the use of mobile phone technology for diabetes self-management with improved clinical outcomes. However, there are few studies to date addressing the application of mobile diabetes management in the Gulf region, particularly in the Kingdom of Saudi Arabia (KSA), where there is exponential increase in mobile phone usage and access to social networking. The objective of this paper is to present the design and development of a new mobile health system for social behavioral change and management tailored for Saudi patients with diabetes called Saudi Arabia Networking for Aiding Diabetes (SANAD). A usability study for the SANAD system is presented to validate the acceptability of using mobile technologies among patients with diabetes in the KSA and the Gulf region. The SANAD system was developed using mobile phone technology with diabetes management and social networking modules. For the usability study the Questionnaire for User Interaction Satisfaction was used to evaluate the usability aspect of the SANAD system. A total of 33 users with type 2 diabetes participated in the study. The key modules of the SANAD system consist of (1) a mobile diabetes management module; (2) a social networking module; and (3) a cognitive behavioral therapy module for behavioral change issues. The preliminary results of the usability study indicated general acceptance of the patients in using the system with higher usability rating in patients with type 2 diabetes. We found that the acceptability of the system was high among Saudi patients with diabetes, and ongoing

  4. Design and Usability Evaluation of Social Mobile Diabetes Management System in the Gulf Region

    Science.gov (United States)

    2016-01-01

    Background The prevalence of diabetes in the Gulf States is one of the highest globally. It is estimated that 20% of the population in the region has been diagnosed with diabetes and according to the International Diabetes Federation (IDF), five of the IDF’s “top 10” countries for diabetes prevalence in 2011 and projected for 2030 are in this region. In recent years, there have been an increasing number of clinical studies advocating the use of mobile phone technology for diabetes self-management with improved clinical outcomes. However, there are few studies to date addressing the application of mobile diabetes management in the Gulf region, particularly in the Kingdom of Saudi Arabia (KSA), where there is exponential increase in mobile phone usage and access to social networking. Objective The objective of this paper is to present the design and development of a new mobile health system for social behavioral change and management tailored for Saudi patients with diabetes called Saudi Arabia Networking for Aiding Diabetes (SANAD). A usability study for the SANAD system is presented to validate the acceptability of using mobile technologies among patients with diabetes in the KSA and the Gulf region. Methods The SANAD system was developed using mobile phone technology with diabetes management and social networking modules. For the usability study the Questionnaire for User Interaction Satisfaction was used to evaluate the usability aspect of the SANAD system. A total of 33 users with type 2 diabetes participated in the study. Results The key modules of the SANAD system consist of (1) a mobile diabetes management module; (2) a social networking module; and (3) a cognitive behavioral therapy module for behavioral change issues. The preliminary results of the usability study indicated general acceptance of the patients in using the system with higher usability rating in patients with type 2 diabetes. Conclusions We found that the acceptability of the system was

  5. Evaluating the potential for catastrophic fault-rupture-related hazards affecting a key hydroelectric and irrigation region in central Asia

    Science.gov (United States)

    Rust, D.; Korjenkov, A.; Tibaldi, A.; Usmanova, M.

    2009-04-01

    The Toktogul hydroelectric and irrigation scheme is the largest in central Asia, with a reservoir containing almost 20 km3 of water behind a 230 m-high dam. Annually, the scheme generates 1200 MW of electricity that is distributed over Kyrgyzstan, Uzbekistan, Tajikistan, Kazakhstan and Russia. The scheme is vital for the economic, social and agricultural stability and development of the emerging central Asian republics it serves and, since it is no longer administered centrally as it was in Soviet times, is increasingly the focus of cross-border tensions involving competing needs for irrigation water and power supplies. Our work aims to identify and evaluate potential geo-environmental threats to this region for the benefit of stakeholders; with recommendations for measures to mitigate a range of threat scenarios, presented in a user-friendly GIS format. Most notably these scenarios involve the potential for very large magnitude earthquakes, with associated widespread slope instability, occurring on the little known Talas - Fergana fault. This structure, some 700 km long, bisects the Toktogul region within the actively (~20 mm a-1) contracting Tien Shan mountain range and exhibits geological characteristics similar to large strike-slip faults such as the San Andreas. Historical records are limited in this inaccessible mountainous region that, until Soviet times, was occupied by mainly nomadic peoples, but do not indicate recent fault rupture. This highlights the role of geological investigations in assembling a record of past catastrophic events to serve as a guide for what may be expected in the future, as well as the inherent difficulties in attempting geological forecasts to a precision that is useful on human timescales. Such forecasts in this region must also include the presence of some 23 uranium mining waste dumps within the mountain valleys, a legacy from Soviet times, as well as arsenic-rich waste dumps remaining from an earlier era of gold mining. Many

  6. The Evaluation of Screening and Early Detection Strategies for Type 2 Diabetes and Impaired Glucose Tolerance (DETECT-2) update of the Finnish diabetes risk score for prediction of incident type 2 diabetes

    DEFF Research Database (Denmark)

    Alssema, M; Vistisen, D; Heymans, M W

    2011-01-01

    AIMS/HYPOTHESIS: The Finnish diabetes risk questionnaire is a widely used, simple tool for identification of those at risk for drug-treated type 2 diabetes. We updated the risk questionnaire by using clinically diagnosed and screen-detected type 2 diabetes instead of drug-treated diabetes...... as an endpoint and by considering additional predictors. METHODS: Data from 18,301 participants in studies of the Evaluation of Screening and Early Detection Strategies for Type 2 Diabetes and Impaired Glucose Tolerance (DETECT-2) project with baseline and follow-up information on oral glucose tolerance status...... of the original Finnish risk questionnaire could be improved by adding information on sex, smoking and family history of diabetes. The DETECT-2 update of the Finnish diabetes risk questionnaire is an adequate and robust predictor for future screen-detected and clinically diagnosed type 2 diabetes in Europid...

  7. Evaluation of plasma-ionized magnesium concentration in 122 dogs with diabetes mellitus: a retrospective study.

    Science.gov (United States)

    Fincham, Suzanne C; Drobatz, Kenneth J; Gillespie, Tracey N; Hess, Rebecka S

    2004-01-01

    The goal of this study was to evaluate plasma-ionized magnesium (iMg2+) concentration in a large group of dogs with naturally occurring diabetes mellitus and to determine whether dogs with diabetes mellitus have hypomagnesemia, as reported in diabetic humans and cats. Plasma iMg2+ concentrations were retrospectively evaluated at the time of initial examination of 122 diabetic dogs at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. Diabetic dogs were defined as having uncomplicated diabetes mellitus (DM, 78 dogs) diabetic ketoacidosis (DKA, 32 dogs), or ketotic nonacidotic diabetes mellitus (DK, 12 dogs) on the basis of presence or absence of metabolic acidosis or ketonuria. Twenty-two control dogs were used to determine reference values for plasma iMg2+ concentration in healthy dogs. Plasma iMg2+ concentration also was evaluated in 19 nondiabetic dogs with acute pancreatitis because many of the dogs with DKA had concurrent acute pancreatitis. Plasma iMg2+ concentration was significantly higher in dogs with DKA (median 0.41 mmol/L, reference range 0.14-0.72 mmol/L) than in dogs with DM (0.33 mmol/L, 0.17-0.65 mmol/L; P = .0002) or the control group (0.32 mmol/L, 0.26-0.41 mmol/L; P = .006). There were no significant differences between plasma iMg2+ concentrations in dogs with DM or DK compared with control dogs. We conclude that dogs with naturally occurring diabetes mellitus do not have marked hypomagnesemia on initial examination at a tertiary care center.

  8. Evaluation of the anti-diabetic property of Morinda lucida leaves in streptozotocin-diabetic rats.

    Science.gov (United States)

    Olajide, O A; Awe, S O; Makinde, J M; Morebise, O

    1999-11-01

    The hypoglycaemic and anti-hyperglycaemic activities of a methanol extract of Morinda lucida Benth. (Rubiaceae) leaves were studied in normal and streptozotocin-diabetic rats. In normal rats, the extract demonstrated a significant (P Morinda lucida have a strong glucose lowering property when administered to streptozotocin-treated rats.

  9. Evaluation of anti-hyperglycemic activities of phloridzin in diabetic ...

    African Journals Online (AJOL)

    Background: The aim of the study was to investigate the hypoglycemic effects of Phloridzin. Methods and Materials: High fat diet induced diabetic KKAy mice were administered with phloridzin at an oral dose (60 mg/kg/day, ig.) for 10 weeks. A range of parameters, including blood glucose and lipid, serum insulin, glucose ...

  10. Contemporary Evaluation and Management of the Diabetic Foot

    Directory of Open Access Journals (Sweden)

    Bauer E. Sumpio

    2012-01-01

    Full Text Available Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field.

  11. Contemporary Evaluation and Management of the Diabetic Foot

    Science.gov (United States)

    Sumpio, Bauer E.

    2012-01-01

    Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field. PMID:24278695

  12. Diabetes

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for diabetes. The data is provided by three managed care organizations in Allegheny County (Gateway Health Plan,...

  13. Follow the LEADER-Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results Trial.

    Science.gov (United States)

    Kalra, Sanjay

    2016-12-01

    This commentary analyzes the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial, which has reported the cardiovascular benefits of liraglutide. It places the results of this seminal trial in the context of the evolution of diabetes care, compares them with other recently published cardiovascular outcome trials, and suggests novel mechanisms to explain the benefits and properties of liraglutide. The editorial discusses the potential impact that LEADER will have on the prevention and management of diabetes and its vascular complications.

  14. Evaluation of blood glucose in type II diabetic patients submitted to local anesthesia with different vasoconstrictors

    OpenAIRE

    MELLO, Renan Pollettini de; Ramacciato, Juliana Cama; PERUZZO, Daiane Cristine; Vicentini,Carllini Barroso; Bergamaschi,Cristiane de Cássia; Motta,Rogério Heládio Lopes

    2016-01-01

    ABSTRACT Objective: In the dental clinic, the use of local anesthetics containing vasoconstrictors in diabetic patients are still controversial raising some doubts. Thus, the objective of this randomized crossover clinical trial was to evaluate blood glucose, pulse oximetry and heart rate of type 2 diabetic patients when submitted to local anesthesia using prilocaine 3% associated to felypressin 0,03UI / ml (G1) and 2% lidocaine associated to epinephrine 1: 100,000 (G2). Methods: The sample...

  15. DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

    Directory of Open Access Journals (Sweden)

    Kiss Alex

    2009-05-01

    Full Text Available Abstract Background The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. Methods and design The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. Discussion The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Trial Registration Protocol NCT00325624

  16. Trends in diabetes-related lower extremities amputations in Romania-A five year nationwide evaluation.

    Science.gov (United States)

    Veresiu, Ioan Andrei; Iancu, Silvia Stefania; Bondor, Cosmina

    2015-08-01

    The aim of the study was to perform a nationwide evaluation of the frequency, incidence and trends of diabetes-related LEA (lower extremities amputations) in Romania. We have retrospectively analysed DRG data (ICD 10 AM codes) from all hospitals in the country, over a 5 year period (2006-2010). Knowing the shortcomings of this approach, we have assumed that our study can serve as a platform for future comparisons. The total number of non-traumatic diabetes related LEA procedures was 24,312, they were performed in 16,873 patients with diabetes, 22.55% with type 1 diabetes, 70.26 with type 2 diabetes and 7.19% with non-specified diabetes at discharge. The total number of hospital admissions for these patients was 46,985. During the five years of the study there was an increase in the absolute number of major amputations (above the ankle), as well as of minor amputations. The rate of amputations decreased in type 1 diabetes, from baseline (2006): -8.15% in 2007, -25.83% in 2008, -23.43% in 2009, -27.71% in 2010, whereas it increased in type 2 diabetes in the respective years: 16.96%, 60.75%, 66.91%, and 104.64%, due to an increase in minor amputations and mainly in elderly people. Male: female amputations rate was 2:1 in type 1 diabetes patients and 2.4:1 in type 2 diabetes patients. This study, the first of its kind in the Romanian population, offers a starting point for future comparisons and identifies a target for preventive measures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. The rescue and evaluation of FLAG and HIS epitope-tagged Asia 1 type foot-and-mouth disease viruses.

    Science.gov (United States)

    Yang, Bo; Yang, Fan; Zhang, Yan; Liu, Huanan; Jin, Ye; Cao, Weijun; Zhu, Zixiang; Zheng, Haixue; Yin, Hong

    2016-02-02

    The VP1 G-H loop of the foot-and-mouth disease virus (FMDV) contains the primary antigenic site, as well as an Arg-Gly-Asp (RGD) binding motif for the αv-integrin family of cell surface receptors. We anticipated that introducing a foreign epitope tag sequence downstream of the RGD motif would be tolerated by the viral capsid and would not destroy the antigenic site of FMDV. In this study, we have designed, generated, and characterized two recombinant FMDVs with a FLAG tag or histidine (HIS) inserted in the VP1 G-H loop downstream of the RGD motif +9 position. The tagged viruses were genetically stable and exhibited similar growth properties with their parental virus. What is more, the recombinant viruses rFMDV-FLAG and rFMDV-HIS showed neutralization sensitivity to FMDV type Asia1-specific mAbs, as well as to polyclonal antibodies. Additionally, the r1 values of the recombinant viruses were similar to that of the parental virus, indicating that the insertion of FLAG or HIS tag sequences downstream of the RGD motif +9 position do not eradicate the antigenic site of FMDV and do not affect its antigenicity. These results indicated that the G-H loop of Asia1 FMDV is able to effectively display the foreign epitopes, making this a potential approach for novel FMDV vaccines development. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Development and pilot evaluation of literacy-adapted diabetes and CVD education in urban, diabetic African Americans.

    Science.gov (United States)

    Hill-Briggs, Felicia; Renosky, Ronda; Lazo, Mariana; Bone, Lee; Hill, Martha; Levine, David; Brancati, Frederick L; Peyrot, Mark

    2008-09-01

    Despite prevalent low literacy nationally, empirical research on the development and testing of literacy-adapted patient education remains limited. To describe procedures for developing and evaluating usability and acceptability of an adapted diabetes and CVD patient education. Materials adaptation for literacy demand and behavioral activation criteria, and pre-/post-test intervention evaluation design. Pilot sample of 30 urban African-American adults with type 2 diabetes with Below Average literacy (n = 15) and Average literacy (n = 15). Wide Range Achievement Test (WRAT-3, Reading), assessment of diabetes and CVD knowledge, and patient rating scale. Reading grade levels were: > 12th, 30%; 10th-12th, 20%; 7th-9th, 10%; 4th-6th grade, 10%; and Education materials were modified to a reading level of education, in the number of participants responding correctly to some content items. The print materials and class received maximum usability and acceptability ratings from patients. Development of patient education meeting very low literacy criteria was feasible, effective for knowledge acquisition, and highly acceptable irrespective of literacy level.

  19. Evaluation of the Impact of a Diabetes Education Curriculum for School Personnel on Disease Knowledge and Confidence in Caring for Students

    Science.gov (United States)

    Smith, Cory T.; Chen, Aleda M. H.; Plake, Kimberly S.; Nash, Christiane L.

    2012-01-01

    Background: School personnel may lack knowledge of diabetes and be unprepared to address the needs of students with type 1 diabetes. This project evaluated the effectiveness of a type 1 diabetes education program for school personnel on increasing knowledge of diabetes and confidence in caring for students with diabetes. Methods: Two types of…

  20. Non-alcohol fatty liver disease in Asia: Prevention and planning.

    Science.gov (United States)

    Ashtari, Sara; Pourhoseingholi, Mohamad Amin; Zali, Mohamad Reza

    2015-07-08

    To review all of epidemiological aspects of non-alcoholic fatty liver disease (NAFLD) and also prevent this disease is examined. We conducted a systematic review according to the PRISMA guidelines. All searches for writing this review is based on the papers was found in PubMed (MEDLINE), Cochrane database and Scopus in August and September 2014 for topic of NAFLD in Asia and the way of prevention of this disease, with no language limitations. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. NAFLD is the most common liver disorder in worldwide, with an estimated with 20%-30% prevalence in Western countries and 2%-4% worldwide. The prevalence of NAFLD in Asia, depending on location (urban vs rural), gender, ethnicity, and age is variable between 15%-20%. According to the many studies in the world, the relationship between NAFLD, obesity, diabetes mellitus, and metabolic syndrome (MS) is quiet obvious. Prevalence of NAFLD in Asian countries seems to be lower than the Western countries but, it has increased recently due to the rise of obesity, type 2 diabetes and MS in this region. One of the main reasons for the increase in obesity, diabetes and MS in Asia is a lifestyle change and industrialization. Today, NAFLD is recognized as a major chronic liver disease in Asia. Therefore, prevention of this disease in Asian countries is very important and the best strategy for prevention and control of NAFLD is lifestyle modifications. Lifestyle modification programs are typically designed to change bad eating habits and increase physical activity that is associated with clinically significant improvements in obesity, type 2 diabetes and MS. Prevention of NAFLD is very important in Asian countries particularly in Arab countries because of high prevalence of obesity, diabetes and MS.

  1. Evaluation of the effectiveness of diabetic nephropathy stage III in patients with type 2 diabetes mellitus therapy with sulodexide

    Directory of Open Access Journals (Sweden)

    V. G. Kadzharyan

    2013-08-01

    Full Text Available Introduction. Diabetes mellitus (DM - takes the main place in the structure of endocrine diseases, and the third after cardiovascular and cancer pathology. In Ukraine 1.2 million of people suffer from diabetes and type 2 diabetes occurs in 85-90% of them. In 2004, 3.4 million of people died from diabetes complications. Diabetic nephropathy (DN is a serious chronic complication of diabetes that leads to the formation of nodular or diffuse glomerulosclerosis. It is the most frequent cause of terminal chronic renal failure (CRF in the world, accounting for over 25% of all cases of CRF. The generally accepted classification is Moggensen`s classification (1983, WHO, according to which five stages of diabetic nephropathy are identified, the first two stages of them are preclinical. Leading role in the pathogenesis of DN takes hyperglycemia, which is implemented by the phenomenon of glucosetoxicity. A lot of facts underscore the importance of inflammatory mechanisms triggered by cytokines. There's immune and non-immune theory of DN. The basis of non-immune theory is a violation of the synthesis of glycosaminoglycans (GAGs that are a major component of the glomerular basement membrane (GMB. GAGs create its negative charge, which prevents the passage through the renal filter small negatively charged molecules, including albumin. In hemodynamic regulation leading role belongs to the renin-angiotensin-aldosterone system (RAAS. The blockade of the RAAS system with ACE inhibitors is the basis of a treatment strategy of DN. All mentioned above became a reason for study of the possibility of a new direction in the treatment of DN using the drug sulodexid, which is a natural mixture of GAGs. Objective of the research. Evaluating the effectiveness of sulodexide therapy of DN stage III in patients with type 2 diabetes. Materials and methods. The patients were divided into 2 groups. Group I consisted of 24 patients aged 40 to 68 years. 5 of them were women and 19

  2. Evaluating the "Healthy Diabetes" Caribbean Food Plate and Website Portal for Diabetes Prevention and Management: Results of an Online Study and Implications for Reducing Health Disparities

    Science.gov (United States)

    Thomas, Nigel M.

    2013-01-01

    Given the challenge of cooking traditional Caribbean meals so they are consistent with the goals of diabetes prevention and management, the researcher created and evaluated a new website portal as e-health tailored to be culturally appropriate and teach the following: how to cook and prepare "Healthy Diabetes" Caribbean Plates. A social…

  3. An evaluation of structural changes in diabetic neuropathy. Clinical study with magnetic resonance imaging (MRI)

    Energy Technology Data Exchange (ETDEWEB)

    Yasuda, Kikuko; Suzuki, Eiji; Shibata, Toshiroh [Gifu Univ. (Japan). School of Medicine] [and others

    1996-01-01

    To investigate changes in tissue hydration and structural changes in diabetic patients using an MRI scanner (SIGNA 1.5-Tesla) with an extremity coil, spin-lattice relaxation time (T{sub 1} value), cross-sectional area, and coefficient of variation (CV value) of signal intensities of the sural nerve, respectively, were determined as indexes of nerve edema, nerve swelling or shrinkage and structural change, and were calculated in normal subjects (normal group, n=7) and diabetic patients (diabetic group, n=33). T{sub 1} value of the sural nerve, but not muscle or adipose tissue, was significantly prolonged in diabetic group (1000{+-}273 vs 702{+-}324 msec, P<0.01), indicating the presence of nerve edema in the diabetic group. There were no differences in cross-sectional area. CV values were significantly higher in the diabetic group (P<0.05). T{sub 1} values were positively correlated with glycemic control (fasting plasma glucose: r=40, HbA{sub 1}c: r=0.35) (P<0.05) and negatively correlated with motor nerve conduction velocity (r=-0.42, P<0.01). These findings indicate that MRI is of value in the objective evaluation of structural changes in diabetic neuropathy. (author).

  4. Evaluation of Cognitive Functions in Iranian Children and Adolescents With Diabetes Mellitus.

    Science.gov (United States)

    Pourabbasi, Ata; Tehrani-Doost, Mehdi; Ebrahimi Qavam, Soqra; Farzami, Jalal; Larijani, Bagher

    2017-06-01

    Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes.

  5. Evaluation of Cognitive Functions in Iranian Children and Adolescents With Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Ata Pourabbasi

    2017-08-01

    Full Text Available Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes.

  6. Evaluation of the Role of Enteral Nutrition in Managing Patients with Diabetes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2014-11-01

    Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor dietary regimes and genetic susceptibility. The development of diabetes often leads to complications such as stroke, which may require enteral nutritional support. The provision of enteral feeds comes with its complications including hyperglycaemia which if not managed can have profound consequences for the patients in terms of clinical outcomes. Therefore, it is essential to develop strategies for managing patients with diabetes on enteral feed with respect to the type and composition of the feed. This is a systematic review of published peer reviewed articles. EBSCOhost Research, PubMed and SwetsWise databases were searched. Reference lists of identified articles were reviewed. Randomised controlled trials comparing enteral nutrition diabetes specific formulas with standard formulas were included. The studies which compared diabetes specific formulas (DSF with standard formulas showed that DSF was more effective in controlling glucose profiles including postprandial glucose, HbA1c and insulinemic response. The use of DSF appears to be effective in managing patients with diabetes on enteral feed compared with standard feed.

  7. Evaluating the effectiveness of an empowerment program for self-care in type 2 diabetes: a cluster randomized trial

    National Research Council Canada - National Science Library

    Cortez, Daniel Nogueira; Macedo, Maísa Mara Lopes; Souza, Débora Aparecida Silva; dos Santos, Jéssica Caroline; Afonso, Gesana Sousa; Reis, Ilka Afonso; Torres, Heloísa de Carvalho

    2017-01-01

    .... This study evaluated the effectiveness of an empowerment program providing support for psychosocial, behavioral, and clinical aspects of diabetes to help Brazilian users of public health services...

  8. Air quality modeling with WRF-Chem v3.5 in East Asia: sensitivity to emissions and evaluation of simulated air quality

    Science.gov (United States)

    Zhong, Min; Saikawa, Eri; Liu, Yang; Naik, Vaishali; Horowitz, Larry W.; Takigawa, Masayuki; Zhao, Yu; Lin, Neng-Huei; Stone, Elizabeth A.

    2016-04-01

    We conducted simulations using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) version 3.5 to study air quality in East Asia at a spatial resolution of 20 km × 20 km. We find large discrepancies between two existing emissions inventories: the Regional Emission Inventory in ASia version 2 (REAS) and the Emissions Database for Global Atmospheric Research version 4.2 (EDGAR) at the provincial level in China, with maximum differences of up to 500 % for CO emissions, 190 % for NO, and 160 % for primary PM10. Such discrepancies in the magnitude and the spatial distribution of emissions for various species lead to a 40-70 % difference in surface PM10 concentrations, 16-20 % in surface O3 mixing ratios, and over 100 % in SO2 and NO2 mixing ratios in the polluted areas of China. WRF-Chem is sensitive to emissions, with the REAS-based simulation reproducing observed concentrations and mixing ratios better than the EDGAR-based simulation for July 2007. We conduct additional model simulations using REAS emissions for January, April, July, and October of 2007 and evaluate simulations with available ground-level observations. The model results illustrate clear regional variations in the seasonal cycle of surface PM10 and O3 over East Asia. The model meets the air quality model performance criteria for both PM10 (mean fractional bias, MFB ⩽ ±60 %) and O3 (MFB ⩽ ±15 %) at most of the observation sites, although the model underestimates PM10 over northeastern China in January. The model predicts the observed SO2 well at sites in Japan, while it tends to overestimate SO2 in China in July and October. The model underestimates observed NO2 in all 4 months. Our study highlights the importance of constraining emissions at the provincial level for regional air quality modeling over East Asia. Our results suggest that future work should focus on the improvement of provincial-level emissions especially estimating primary PM, SO2, and NOx.

  9. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes.

    Science.gov (United States)

    Abate, Michele; Schiavone, Cosima; Salini, Vincenzo

    2010-12-07

    The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively), who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p shoulder symptomatic pathologies.

  10. Evaluation of oral mucosal epithelium in diabetic male patients by exfoliative cytology method.

    Science.gov (United States)

    Seifi, Safoura; Feizi, Farideh; Moazzezi, Zoleikhah; Mehdizadeh, Mohammad; Zamani, Babak

    2014-01-01

    The goal of present study is to examine comparatively the epithelium of oral mucosa in persons with diabetes types I and II and the healthy persons by cytomorphometric method. Cytology smear was prepared from oral mucosa epithelium in 24 persons with diabetes and 30 healthy persons were stained by papanicolao method. Its before, from patients were requested acquiring written. The quantitative cytomorphometric characteristics were measured in each group by motic plus 2 software. Also, the qualitative evaluation of cytology slides are performed in three groups. There were decrease in the nuclear and cytoplasmic size, (P < 0.001) and increase in the ratio of nuclear to cytoplasm size in buccal mucosal areas (P = 0.001) and tongue (P = 0.011) of diabetic persons compared to the healthy persons. There was no significantly statistical difference in diabetic persons types I and II in buccal mucosal area (P = 0.15) and tongue (P = 0.86) in quantitative characteristics of cytomoerphometry. In nuclear and cytoplasm size, there was a significant statistical difference in persons with diabetes type I and persons of control I and persons with diabetes type II and persons of control II in buccal mucosa and the tongue (P < 0.001). Bilobed or multi-lobed nuleous, karyorrhexis and vacuolization of cytoplasm were more in diabetic persons compared to the healthy ones (P < 0.001). Diabetes are effective in creating some quantitative and qualitative cytometric alterations in the oral mucosa but the type of diabetes doesn't seem to be effective on these changes.

  11. Evaluation of salivary glucose, amylase, and total protein in Type 2 diabetes mellitus patients.

    Science.gov (United States)

    Indira, M; Chandrashekar, P; Kattappagari, Kiran Kumar; Chandra, Lalith Prakash K; Chitturi, Ravi Teja; Bv, Ramana Reddy

    2015-01-01

    Diabetes mellitus is a complex multisystem metabolic disorder characterized by a deficit in the production of insulin. The oral complications of uncontrolled diabetes mellitus are devastating. Saliva is an organic fluid that can be collected noninvasively and by individuals with limited training. These reasons create an interest in evaluating the possibility of using saliva as a diagnostic tool. The aim of this study was to determine, if saliva can be used as a noninvasive tool to monitor glycemic control in Type 2 diabetes. Comparative assessment of salivary (glucose, amylase, total protein levels) in patients with Type 2 diabetes and controls. A total of 40 individuals, 20 with Type 2 diabetes and 20 controls of age group 40-60 years were selected for the study. Diabetic status was assessed by estimating random blood glucose levels. Unstimulated saliva was collected from each participant and investigated for glucose, amylase, and total protein levels. Salivary glucose estimation was performed using glucose-oxidase method, amylase by the direct substrate kinetic enzymatic method, and total protein by pyrogallol red dye end point method. All the parameters were subjected to statistical analysis using SPSS version 20.0. Significantly higher salivary glucose, lower amylase, and total proteins were observed in patients with Type 2 diabetes than controls. There was no significant correlation between salivary and blood glucose levels. These results suggest that diabetes influences the composition of saliva. Since a significant correlation was not observed between salivary and blood glucose levels, further research is needed to determine salivary glucose estimation as a diagnostic tool for diabetes mellitus.

  12. Psychometric evaluation of the Korean version of the Diabetes Self-efficacy Scale among South Korean older adults with type 2 diabetes.

    Science.gov (United States)

    Chang, Sun Ju; Song, Misoon; Im, Eun-Ok

    2014-08-01

    To evaluate the psychometric properties (reliability and validity) of the Korean version of the Diabetes Self-efficacy Scale among South Korean older adults with type 2 diabetes mellitus. Self-efficacy has been reported to be a key component of enhancing diabetes self-management, and many healthcare providers have paid attention to the instruments to accurately measure self-efficacy as related to diabetes self-management. A psychometric test of an instrument measuring self-efficacy as related to diabetes self-management. A total of 278 Korean older adults with type 2 diabetes were recruited in one senior centre in Seoul, South Korea. The instrument included the Diabetes Self-efficacy Scale and the summary of the Diabetes Self-care Activities. Item analyses, reliability including internal consistency and stability, and validity including exploratory factor analysis, confirmatory factor analysis, and hypothesised relationships test were used to examine the psychometric properties of the Korean version of the Diabetes Self-efficacy Scale. The item-total correlation coefficients of all items were >0·30 and ranged from 0·47-0·73. The coefficient alpha for the internal consistency was 0·89, and the intraclass correlation coefficient for the stability was 0·90. Two factors were extracted from the exploratory factor analysis (factor 1, self-efficacy for diet-related self-management behaviours; factor 2, self-efficacy for diabetes self-management behaviours except diet), and the two-factor model for the confirmatory factor analysis had good fitness indices. The diabetes self-efficacy scores were positively correlated with the level of diabetes self-management. The findings supported that the Korean version of the Diabetes Self-efficacy Scale was reliable and valid in measuring self-efficacy as related to diabetes self-management in Korean older adults with type 2 diabetes. The Korean version of the Diabetes Self-efficacy Scale can allow healthcare providers to

  13. The Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE): Construct and Content Validation Using a Modified Delphi Method.

    Science.gov (United States)

    Paquette-Warren, Jann; Tyler, Marie; Fournie, Meghan; Harris, Stewart B

    2017-06-01

    In order to scale-up successful innovations, more evidence is needed to evaluate programs that attempt to address the rising prevalence of diabetes and the associated burdens on patients and the healthcare system. This study aimed to assess the construct and content validity of the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE), a tool developed to guide the evaluation, design and implementation with built-in knowledge translation principles. A modified Delphi method, including 3 individual rounds (questionnaire with 7-point agreement/importance Likert scales and/or open-ended questions) and 1 group round (open discussion) were conducted. Twelve experts in diabetes, research, knowledge translation, evaluation and policy from Canada (Ontario, Quebec and British Columbia) and Australia participated. Quantitative consensus criteria were an interquartile range of ≤1. Qualitative data were analyzed thematically and confirmed by participants. An importance scale was used to determine a priority multi-level indicator set. Items rated very or extremely important by 80% or more of the experts were reviewed in the final group round to build the final set. Participants reached consensus on the content and construct validity of DEFINE, including its title, overall goal, 5-step evaluation approach, medical and nonmedical determinants of health schematics, full list of indicators and associated measurement tools, priority multi-level indicator set and next steps in DEFINE's development. Validated by experts, DEFINE has the right theoretic components to evaluate comprehensively diabetes prevention and management programs and to support acquisition of evidence that could influence the knowledge translation of innovations to reduce the burden of diabetes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Clinical Evaluation of OneTouch Diabetes Management Software System in Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Kim, Jung Min; Lee, Hey Jean; Kim, Keum Ok; Won, Jong Chul; Ko, Kyung Soo; Rhee, Byung Doo

    2016-04-01

    OneTouch Diabetes Management Software (OTDMS) is an efficient way to track and monitor the blood glucose level. It is possible to download data from the OneTouch Ultra via the meter's data port, and to transform the numbers of the blood glucose level into a graph, a chart, or statistics. The objectives of this study were to evaluate whether the use of OTDMS in consultation hours would improve patients' knowledge of diabetes mellitus (DM), compliance, satisfaction with doctor and medical treatment, doctor-patient reliability, and glucose control. All patients were randomized into either the OTDMS group using OneTouch Ultra or the control groups not using it. Both groups had conventional DM education and only the OTDMS group used data from OTDMS as explanation materials during consultation hours. At enrollment and after 6 months, we performed a questionnaire survey consisting of the diabetes knowledge test, items for compliance of treatment, patient's satisfaction, doctor-patient reliability, and glycosylated hemoglobin (HbA1c). We analyzed 6-month follow-up data from 92 patients (OTDMS 42 vs. control 50). Both groups showed significant improvements in HbA1c, diabetes knowledge, compliance, reliability, and satisfaction after 6 months. However, there were no significant differences between OTDMS and control groups overall. Only "weekly frequency of checking blood glucose level" of compliance and "trying to follow doctor's order" of reliability showed better results in the OTDMS group. Using the OTDMS system for explanation during consultation hours seems to be more helpful to improve patient's compliance and reliability, especially for checking blood glucose level and trying to follow the doctor's order.

  15. Educational Gaming for Pharmacy Students - Design and Evaluation of a Diabetes-themed Escape Room.

    Science.gov (United States)

    Eukel, Heidi N; Frenzel, Jeanne E; Cernusca, Dan

    2017-09-01

    Objective. To design an educational game that will increase third-year professional pharmacy students' knowledge of diabetes mellitus disease management and to evaluate their perceived value of the game. Methods. Faculty members created an innovative educational game, the diabetes escape room. An authentic escape room gaming environment was established through the use of a locked room, an escape time limit, and game rules within which student teams completed complex puzzles focused on diabetes disease management. To evaluate the impact, students completed a pre-test and post-test to measure the knowledge they've gained and a perception survey to identify moderating factors that could help instructors improve the game's effectiveness and utility. Results. Students showed statistically significant increases in knowledge after completion of the game. A one-sample t-test indicated that students' mean perception was statistically significantly higher than the mean value of the evaluation scale. This statically significant result proved that this gaming act offers a potential instructional benefit beyond its novelty. Conclusion. The diabetes escape room proved to be a valuable educational game that increased students' knowledge of diabetes mellitus disease management and showed a positive perceived overall value by student participants.

  16. Evaluation the index of ophthalmic arteries in diabetic patients with retinopathy compared to diabetic patients without retinopathy using color Doppler ultrasound

    Directory of Open Access Journals (Sweden)

    Mohammad Ghasem Hanafi

    2016-12-01

    Full Text Available Diabetic retinopathy is the most common eye complication in diabetic patients that early detection of this complication is essential. The aim of this study was to evaluate ophthalmic artery index in diabetic retinopathy by Doppler ultrasound. . In this cross-sectional study, 64 patients were studied in 4 groups (healthy, diabetic without retinopathy, background retinopathy and proliferative retinopathy. Resistance index (RI and Pulsatile Index (PI were assessed by color Doppler ultrasound. The obtained data were analyzed by ANOVA and chi-square test and ROC curve. RI in diabetic patients with proliferative retinopathy has the highest mean (0.83 and the lowest mean was observed in healthy subjects (0.54 (P <0.001 as well as in PI, the highest rate was in diabetic patients with proliferative retinopathy (1.41 and the lowest was in healthy subjects (0.92 (P <0.001. The results of our study showed that the sensitivity, specificity, positive and negative predictive values and overall accuracy of RI and PI in diabetic patients with proliferative retinopathy in the best cut-off points (0.645 and 1.0175 respectively were 100%.Ophthalmic artery index RI and PI was significantly increased in patients with diabetic retinopathy and the sensitivity and specificity for detection retinopathy was 100%. Color Doppler ultrasound method is more efficient for screening diabetic patients with retinopathy.

  17. Heart Rate Variability as Early Biomarker for the Evaluation of Diabetes Mellitus Progress

    Directory of Open Access Journals (Sweden)

    Rosa Elena Arroyo-Carmona

    2016-01-01

    Full Text Available According to the American Diabetes Association (ADA, the side effects of diabetes mellitus have recently increased the global health expenditure each year. Of these, the early diagnostic can contribute to the decrease on renal, cardiovascular, and nervous systems complications. However, the diagnostic criteria, which are commonly used, do not suggest the diabetes progress in the patient. In this study, the streptozotocin model in mice (cDM was used as early diagnostic criterion to reduce the side effects related to the illness. The results showed some clinical signs similarly to five-year diabetes progress without renal injury, neuropathies, and cardiac neuropathy autonomic in the cDM-model. On the other hand, the electrocardiogram was used to determine alterations in heart rate and heart rate variability (HRV, using the Poincaré plot to quantify the HRV decrease in the cDM-model. Additionally, the SD1/SD2 ratio and ventricular arrhythmias showed increase without side effects of diabetes. Therefore, the use of HRV as an early biomarker contributes to evaluating diabetes mellitus complications from the diagnostic.

  18. Diabetic peripheral neuropathy and its evaluation in a clinical scenario: A review

    Directory of Open Access Journals (Sweden)

    S Dixit

    2014-01-01

    Full Text Available Diabetes mellitus is not only a clinical syndrome characterizing hyperglycemia, but is also a cause of debilitating problem known as peripheral neuropathy (PN. This review addresses the importance of diagnosing PN in a clinical setting as PN causes pain and discomfort in lower extremities, loss or absence of protective sensations in the lower extremities leading to balance problems, risk of foot ulcerations, and a reduced quality of life in adults with type 2 diabetes. A variety of modalities or methods are available to evaluate both subjective and objective measures of peripheral nerve functions, and have been discussed in detail in this review. It is of utmost importance to understand that evaluating PN as a routine practice in a simple way may also play a vitally important role in preventing foot ulcers or fall-related morbidity and mortality in adults with type 2 diabetes.

  19. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

    Directory of Open Access Journals (Sweden)

    Salini Vincenzo

    2010-12-01

    Full Text Available Abstract Background The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. Methods The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively, who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Results Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p vs 3.2 ± 0.4 mm, p vs 20.3%, p vs 7.8%, p Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8% vs 2 (3.1%, p vs 5 (7.8%, p = ns, but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p vs 10.9%, p In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found. Conclusions Our results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics. Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.

  20. ASIAS - Some History

    Data.gov (United States)

    National Aeronautics and Space Administration — The ASIAS effort builds on demonstrations that an open exchange of information contributes to improved aviation safety. ASIAS is a comprehensive effort, covering the...

  1. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

    2017-09-01

    Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

  2. Evaluation and Use of Registry Data in a GIS Analysis of Diabetes

    Directory of Open Access Journals (Sweden)

    Mungrue Kameel

    2015-07-01

    Full Text Available Objectives: to evaluate registry data routinely collected by the Chronic Disease Electronic Management System (CDEMS in the monitoring of type 2 diabetes mellitus (T2DM in the Eastern half of the island and use the data to describe the spatial epidemiological patterns of T2DM. Design and Method: The starting point was access and retrival of all exsisting data on the diabetes registry. This data was subsequently validated using handwritten medical records. Several clinical indicators were selected to evaluate the registry. The address of each patient was extracted and georeferenced using ArcGIS 10.0 and several maps were created. Results: The registry had data for thirteen (13 out of the sixteen (16 health facilities. We found that less than 15 percent of all patients actually had diabetic indicator tests done according to World Health Organization (WHO standards. The overall prevalence of T2DM was 20.8 per 1000 population. The highest prevalence of diabetes occurred at the northeastern tip of the island. In addition 57.58% of patients with T2DM resided inland and 40.75% of patients residing on the coastal areas. Conclusions: In conclusion, we provide evidence that the data collected by the diabetes registry although lacking in many areas was adequate for spatial epidemiological analysis.

  3. Toxicological and safety evaluation of Nigella sativa lipid and volatile fractions in streptozotocin induced diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Muhammad Tauseef Sultan

    2014-09-01

    Full Text Available Objective: To evaluate the toxicological aspects of Nigella sativa (N. sativa lipid and volatile fractions in streptozotocin induced diabetes mellitus. Methods: National Institute of Health (NIH, Islamabad provided us thirty Sprague Dawley rats that were further divided into three groups, i.e. control, N. sativa lipid fraction (4% and N. sativa volatile fraction (0.3%, respectively. The serological and haematological indices were evaluated at 4-week intervals during 56 d study. Results: The results indicated that the diabetes mellitus imparted negative effects on various serological and haematological attributes. However, supplementation of the N. sativa lipid fraction and N. sativa volatile fraction ameliorated the adverse consequences of diabetes mellitus. The diabetes induced renal toxicity and imbalanced serum chemistry were slightly modulated by experimental diets. However, the impact of essential oil was more significant as compared to the fixed oil. Conclusions: In a nutshell, experimental diets containing N. sativa lipid fraction and N. sativa volatile fraction are effective without having any toxicological effects, and experimental diets reduced toxicological and adverse consequences of diabetes mellitus.

  4. Liver function tests and risk prediction of incident type 2 diabetes : evaluation in two independent cohorts

    NARCIS (Netherlands)

    Abbasi, Ali; Bakker, Stephan J. L.; Corpeleijn, Eva; van der A, Daphne L.; Gansevoort, Ron T.; Gans, Rijk O. B.; Peelen, Linda M.; van der Schouw, Yvonne T.; Stolk, Ronald P.; Navis, Gerjan; Spijkerman, Annemieke M. W.; Beulens, Joline W. J.

    2012-01-01

    Background: Liver function tests might predict the risk of type 2 diabetes. An independent study evaluating utility of these markers compared with an existing prediction model is yet lacking. Methods and Findings: We performed a case-cohort study, including random subcohort (6.5%) from 38,379

  5. Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

    Science.gov (United States)

    Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

    2013-01-01

    Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

  6. Evaluation of a target region capture sequencing platform using monogenic diabetes as a study-model

    DEFF Research Database (Denmark)

    Gao, Rui; Liu, Yanxia; Gjesing, Anette Marianne Prior

    2014-01-01

    and next generation sequencing which might be used as an efficient way to diagnose various genetic disorders. We aimed to develop a target-region capture sequencing platform to screen 117 selected candidate genes involved in metabolism for mutations and to evaluate its performance using monogenic diabetes...

  7. Implementing rotavirus vaccination in Asia.

    Science.gov (United States)

    Santosham, Mathuram; Nelson, E Anthony S; Bresee, Joseph S

    2007-11-01

    At the 2006 meeting of the Asian Pacific Pediatric Association (APPA), the Asia Pacific regional rotavirus community and international experts strongly recommended that rotavirus vaccines be used in National Immunization Programmes (NIP) in countries in Asia. Two rotavirus vaccine candidates are currently licensed and have been demonstrated to be safe, well tolerated and highly efficacious. Several additional vaccines are in the late stages of development. The conference participants agreed that decisions on the introduction of rotavirus vaccines may require additional disease burden data in some countries and that economic evaluations will help policymakers reach decisions on nationwide rotavirus vaccine implementation. Other potential issues that arise with vaccine implementation, for example, the concomitant use of rotavirus vaccines with other vaccines, were also discussed. Rotavirus vaccines have the potential to substantially reduce morbidity and mortality from rotavirus disease and impact children's health in Asia.

  8. Evaluation of educational needs in patients with diabetes mellitus in respect of medication use in Austria.

    Science.gov (United States)

    Lemmens-Gruber, Rosa; Hahnenkamp, Christine; Gössmann, Ulrike; Harreiter, Jürgen; Kamyar, Majid-Reza; Johnson, Barbara Julienne; Hudson, Steve; Kautzky-Willer, Alexandra

    2012-06-01

    Effective control of diabetes mellitus type 1 (DM1) and type 2 (DM2) can reduce the development and progression of diabetic complications. Therefore, patient education should be considered as an integral part of diabetes management. The aim of the study was to assess DM patients' perception of knowledge for their medication and attitude towards self-management and pharmacist's role. The study was conducted at the diabetes out-patient clinic at the Vienna General Hospital (AKH), Division of Endocrinology and Metabolism, Department of Internal Medicine III, Austria. The study was a cross sectional survey using patient data from a validated patient questionnaire and medical records. Medical records were evaluated by applying a medication assessment tool. To assess the quality of diabetes self management the following outcome measures are considered: HbA1c levels, pre- and post-prandial blood glucose levels, prevention of acute episodes of hypo- and hyperglycaemia, reduction of macrovascular risk factors, short term quality of life, adverse effects and treatment tolerance. The present study comprised 225 patients with DM1 and 201 patients with DM2, respectively. In comparison to DM2 patients, cardio- and cerebrovascular diseases were diagnosed very rarely in patients with DM1. The risk for these diseases was higher in patients with other factors of the metabolic syndrome, in addition. Overall, 118 of these patients participated in the questionnaire. The level of positive response on diabetes self-care and knowledge with respect to medication for the prevention of diabetes complications, glycaemic control, and treatment goals in diabetes was 81.8 %. The comparison of patients' perceptions of diabetes self-care and knowledge showed differences among subgroups. Higher perceived knowledge and self-care apparently was associated with DM1. Additional findings of this study indicate that patients do not expect community pharmacists to be integrated in a multidisciplinary

  9. D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

    Science.gov (United States)

    Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

    2014-06-01

    To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision

  10. Linagliptin for the treatment of type 2 diabetes (pharmacokinetic evaluation).

    Science.gov (United States)

    Scheen, André J

    2011-12-01

    Dipeptidyl peptidase-4 (DPP-4) inhibitors offer new options for the management of type 2 diabetes (T2DM). The novel compound linagliptin has important different pharmacokinetic (PK) properties, when compared with previously commercialized DPP-4 inhibitors, which may offer some advantages in clinical practice. Linagliptin has a unique PK/pharmacodynamic (PD) profile and is the first DPP-4 inhibitor with a nonrenal elimination route. Therefore, it can be administered in patients with renal impairment without dose adjustment or monitoring of renal function. The drug has a low potential for drug-drug interactions (DDIs) and no clinically relevant ones were reported so far. An extensive literature search was performed to analyse primarily PK and secondarily PD characteristics of linagliptin in both healthy volunteers and patients with T2DM (treated with linagliptin as monotherapy or combined therapy). Updated information about linagliptin PK either after single administration (large dose range) or after chronic administration (steady state) were also included. A special focus has been put on DDIs and on PK/PD of linagliptin in patients with renal impairment. Head-to-head comparative studies and/or increased clinical experience with DPP-4 inhibitors will determine the clinical advantage, if any, of one agent over another.

  11. The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country

    Directory of Open Access Journals (Sweden)

    Julia Lowe

    2015-01-01

    Full Text Available Background. Type 2 diabetes is the fourth leading cause of death in Guyana, South America. A complex, interprofessional, quality improvement intervention to improve foot and diabetes care was rolled out in two phases. Methods & Findings. Phase 1: Establishment of an Interprofessional Diabetic Foot Center (DFC of Excellence to improve foot care and reduce diabetes-related amputations at the national referral hospital. Phase 2: Regionalization to cover 90% of the Guyanese population and expansion to include improved management of diabetes and hypertension. Fourteen key opinion leaders were educated and 340 health care professionals from 97 facilities trained. Eight centers for the evaluation and treatment of foot ulcers were established and 7567 people with diabetes evaluated. 3452 participants had foot screening and 48% were deemed high risk; 10% of these had undocumented foot ulcers. There was a 68% reduction in rate of major amputations (P<0.0001; below knee amputations were decreased by 80%, while above knee amputations were unchanged. An increased association of diabetes with women (F/M = 2.09 and increased risk of major amputation in men [odds ratio 2.16 (95% CI 1.83, 2.56] were documented. Conclusions. This intervention improved foot care with reduction in major amputations sustained over 5 years.

  12. Evaluation of antidiabetic potential of selected traditional Chinese medicines in STZ-induced diabetic mice.

    Science.gov (United States)

    He, Kai; Li, Xuegang; Chen, Xin; Ye, Xiaoli; Huang, Jing; Jin, Yanan; Li, Panpan; Deng, Yafei; Jin, Qing; Shi, Qing; Shu, Hejing

    2011-10-11

    Traditional Chinese medicine (TCM) has been used for treating complex chronic diseases owing to their fewer side-effects, better patient tolerance and relatively less cost. The present work was carried out to study the anti-diabetic efficacy and mechanisms of 34 TCMs. Streptozotocin (STZ)-diabetic mice were orally administrated with corresponding herbal solution once a day for 4 weeks. At the end of experiment, the level of plasma glucose, malondialdehyde (MDA), the activity of superoxide dismutase (SOD) and the serum aldose reductase (AR) were determined, the effects of TCM extract on α-glucosidase and angiotensin-converting enzyme (ACE) in vitro were also evaluated. 13 out of the 34 herbs showed a statistically significant plasma glucose lowering action compared with the diabetic control group. Biochemical analysis revealed that Atractylodes macrocephala, Codonopsis pilosula, Dioscorea opposite, Flos lonicerae and Pueraria lobata may retard the progression of diabetes via reduce the blood glucose level and prevent the increase of AR activity. Other tested herbs, such as Ramulus cinnamomi, Cinnamomum cassia, and Eucommia ulmoides, showed the antidiabetic ability by either prevent the decrease in SOD activity or suppress the increase of MDA. Zymologic assay reveals that Pueraria lobata and Anemarrhena asphodeloides showed the highest inhibition against α-glucosidase and ACE respectively. Interestingly, the post-treatment glucose levels and AR activity were positively correlated with kidney/body weight of 34 herbs treated diabetic mice (p = 0.02, 0.04 respectively). Several potential antidiabetic herbs derived from Chinese traditional pharmacopeia such as Dioscorea opposite, Pueraria lobata, Codonopsis pilosula and Ramulus cinnamomi, have been found to exert a beneficial action on diabetes and diabetic complications via multi-mechanisms. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Clinical evaluation of a new device in the assessment of peripheral sensory neuropathy in diabetes.

    Science.gov (United States)

    Bracewell, N; Game, F; Jeffcoate, W; Scammell, B E

    2012-12-01

    Current National Institute for Health and Clinical Excellence guidelines state that patients with diabetes should have annual examination of their feet to exclude signs of sensory impairment. The VibraTip is a new disposable device producing a vibratory stimulus, which has been developed in order to screen for peripheral sensory neuropathy in diabetes. This study was designed to evaluate the device by assessing intra-rater reliability and comparing the ability of the VibraTip to detect or exclude peripheral sensory neuropathy with other bedside methods. One hundred and forty-one patients with diabetes (Type 1 or Type 2) were examined for diabetic peripheral sensory neuropathy using a Neurothesiometer, 10-g monofilament, a 128-Hz tuning fork, a Neurotip™ and a VibraTip. The failure to perceive the Neurosthesiometer stimulus at ≥ 25 V in either foot was considered the reference method for the presence of peripheral sensory neuropathy. Receiver operating characteristic curves were produced for each device and the sensitivity, specificity, predictive values and likelihood ratios for the diagnosis of peripheral sensory neuropathy were calculated. Repeat testing with the VibraTip was performed in 18 patients and intra-rater reliability assessed using Cronbach alpha. Analysis of the area under the receiver operating characteristic curves showed that the 10-g monofilament was significantly better than the 128-Hz tuning fork (P = 0.0056) and the Neurotip (P = 0.0022), but was no different from the VibraTip (P = 0.3214). The alpha coefficient for the VibraTip was calculated to be 0.882, indicating good reliability. The VibraTip is a device comparable with the 10-g monofilament and therefore could be considered a useful tool for screening for peripheral sensory neuropathy in diabetes. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  14. [Evaluation of adiponectin level in children and adolescents with diabetes type 1].

    Science.gov (United States)

    Peczyńska, Jadwiga; Urban, Mirosława; Głowińska, Barbara; Florys, Bozena

    2008-01-01

    Adipose tissue is not only an energy storage place, but it also secretes numerous "adipocytokines" - substances that have systemic influence. Adiponectin has an anti-inflammatory, antiatherogenic properties and increases insulin sensitivity. It is emphasized that adiponectin levels are different in type 1 and type 2 diabetes. was to evaluate adiponectin levels in young patients with diabetes type 1, and to analyse of the correlation between adiponectin and: BMI, lipid parameters, glomerular filtration rate and microalbuminuria. The study group was formed by 95 patients from the Outpatient Diabetology Department 2nd Department of Children's Diseases, 45 girls and 50 boys, aged from 7 to 20 years (mean - 14.97 yrs) suffering from diabetes from 1 to 17 years (mean 6.68 yrs). Control group consisted of healthy children, age matched, without family history of cardiovascular diseases. In all patients anthropometric measurements were performed (BMI was calculated), metabolic control was evaluated on the basis of HbA1c level, microalbuminuria was studied in 24 hour urine sample. We assessed glomerular filtration rate (endogenous creatinine clearance), lipid parameters and adiponectin level. In children and adolescents with diabetes type 1 we found significantly higher levels of adiponectin compared to control group: 32.72+/-13.49 vs. 26.53+/-7.63 ug/ml; p=0.024. Adiponectin level was higher in girls than in boys (33.56 vs. 28.75 ug/ml; p=0.036). Adiponectin level did not depend on metabolic control and on diabetes duration. We found a statistically significant negative correlation between adiponectin and creatinine (r=-0.26; p=0.011). In patients with diabetic complications we found insignificantly lower adiponectin level compared to patients without complications (30.99+/-14.29 vs. 33.67+/-11.68 ug/ml; p=0.35). 1. In patients with diabetes type 1 significantly higher level of adiponectin was found compared to healthy control group. 2. Adiponectin level correlated

  15. Psychometric evaluation of dietary habits questionnaire for type 2 diabetes mellitus

    Science.gov (United States)

    Sami, W.; Ansari, T.; Butt, N. S.; Hamid, M. R. Ab

    2017-09-01

    This research evaluated the psychometric properties of English version of dietary habits questionnaires developed for type 2 diabetic patients. There is scarcity of literature about availability of standardized questionnaires for assessing dietary habits of type 2 diabetics in Saudi Arabia. As dietary habits vary from country to country, therefore, this was an attempt to develop questionnaires that can serve as a baseline. Through intensive literature review, four questionnaires were developed / modified and subsequently tested for psychometric properties. Prior to pilot study, a pre-test was conducted to evaluate the face validity and content validity. The pilot study was conducted from 23 October - 22 November, 2016 to evaluate the questionnaires’ reliability and validity. Systematic random sampling technique was used to collect the data from 132 patients by direct investigation method. Questionnaires assessing diabetes mellitus knowledge (0.891), dietary knowledge (0.869), dietary attitude (0.841) and dietary practices (0.874) had good internal consistency reliability. Factor analysis conducted on dietary attitude questionnaire showed a valid 5 factor solution. Directions of loadings were positive and free from factorial complexity. Relying on the data obtained from type 2 diabetics, these questionnaires can be considered as reliable and valid for the assessment of dietary habits in Saudi Arabia and neighbouring Gulf countries population.

  16. How people with diabetes evaluate participation of their family in their health care

    Directory of Open Access Journals (Sweden)

    Aliny de Lima Santos

    2014-07-01

    Full Text Available Objective. To understand how individuals with diabetes evaluate the participation of their family in their health care. Methodology. This was a descriptive study with a qualitative approach involving 26 individuals in the Diabetes Association of Maringá. Participating in the study were 9 women and 17 men (age range, 38 to 83 years who had attended at least one educational meeting of the "culture circles" of the association. We used the methodological reference of Paulo Freire for implementing an educational proposal directed at persons with type 2 diabetes mellitus that overcame the limitations of conventional health education approaches. Data were collected between May and July 2011. Testimonials given in meetings were recorded, transcribed, and analyzed according to thematic structures. Results. Three thematic structures appeared: 1 Recognizing the importance of family in the care of patients with diabetes, 2 blaming the family for non-adherence to healthy practices, and 3 perceiving a secondary gain of the disease: feeling cared for by family members. Conclusion. Patients with diabetes perceive family as a source of support and stimulus for adherence and healthy practice, which enable them to control the disease. Family participation in a patient's care plan should be encouraged.

  17. Micronutrients evaluation in Bidens pilosa L., a plant applied in diabetes treatments

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Rodolfo D.M.R.; Silva, Paulo S.C. da, E-mail: rdmrg89@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Diabetes mellitus is a disease that has increasingly affected individuals over the last years. World Health Organization estimates that the worldwide number of diabetes cases will rise from 171 million in 2000 to 366 million in 2030. Besides the therapy with pharmaceutical drugs, many diabetic patients use medicinal plants to control the glycemic levels. This herb has anti-diabetic action due to the presence of organic compounds and micronutrients. Among the plants applied in diabetes treatment, Bidens pilosa L., popularly known in Brazil as picao preto, belongs to the family of Asteraceaes, grows fast and is globally distributed. The aim of this study was evaluate the concentration of Cr, Fe, Mg, Mn, V and Zn in aerial parts of Bidens pilosa samples, as well as its growth substrate by means of instrumental neutron activation analysis (INAA). The samples were separated into two groups named control and treatment. During the plant development, micronutrient solution, containing Cr, Fe, Mg, Mn, V and Zn, was added to the treatment group. It was observed that micronutrient solution added to the Biden pilosa samples may had contributed to the preferentially absorption of Fe, Mg and V, as well as to decrease Zn absorption. (author)

  18. Pearl necklace sign in diabetic macular edema: Evaluation and significance

    Directory of Open Access Journals (Sweden)

    Kshirasagar Ajay

    2016-01-01

    Full Text Available Purpose: (1 The purpose of this study was to describe significance and prevalence of the newly reported pearl necklace spectral domain optical coherence tomography (SDOCT sign, in diabetic macular edema (DMO, (2 to track the course of this sign over a period of at least 10 months. Materials and Methods: The pearl necklace SDOCT sign refers to hyperreflective dots in a contiguous ring around the inner wall of cystoid spaces in the retina, recently described for the first time in 21 eyes with chronic exudative maculopathy. A retrospective analysis was performed of SDOCT images of all patients presenting to the DMO referral clinic of a tertiary eye care center, over a period of 24 months. Images of patients displaying this sign were sequentially analyzed for at least 10 months to track the course of the sign. Results: Thirty-five eyes of 267 patients (13.1% were found to display the pearl necklace sign. Twenty-eight eyes responded to intravitreal ranibizumab treatment with resolution of edema. In 21 eyes, the dots coalesced to form a clump, visible in the infrared fundus photograph as hard exudates; in seven eyes, dots disappeared without leaving visible exudates. In three eyes, the sign was seen in subfoveal cystoid spaces, with subsequent development of hard exudates, and drop in visual acuity of 20 letters or more. Conclusion: Pearl necklace SDOCT sign is not infrequent in DMO. This sign is a precursor to hard exudates in the majority of cases. If this sign is seen subfoveally, drop in visual acuity can be expected, despite treatment.

  19. Synthesis, characterization, and efficacy evaluation of a new anti-diabetic vanadyl(II) thiamine hydrochloride complex in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Ahmed El-Shazly, Samir; Ahmed, Mohamed Mohamed; Ibrahim, Zein Shaban; Refat, Moamen S

    2015-06-01

    Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia due to abnormalities in either insulin secretion or action. A range of vanadium complexes have been synthesized and demonstrated to be effective in lowering hyperglycemia. Thiamine administration was also reported to prevent deterioration in fasting glucose and insulin levels, and to improve glucose tolerance in hyperglycemic patients. This study has been conducted to evaluate the ionic vanadyl(II) thiamine hydrochloride complex (VC) as a new anti-diabetic candidate. The new complex was characterized by infrared spectroscopy (FT-IR), electronic spectra, magnetic susceptibility, electron spin resonance (ESR), scanning electron microscopy (SEM), and thermogravimetric analysis (TGA). The anti-diabetic effect of VC was investigated in comparison to vanadium sulfate in streptozotocin (STZ)-induced diabetic rats. Treatment of diabetic rats with VC versus vanadyl sulfate showed a more potent effect on reducing serum glucose and cholesterol close to normal levels. VC suppressed the diabetes-induced upregulation of hepatic glucose transporter (GLUT)-2, Phosphoenol pyruvate carboxykinase (PEPCK), and hormone-sensitive lipase (HSL) more significantly than vanadyl sulfate. Either vanadyl sulfate or VC restored hepatic sterol regulatory element-binding protein transcription factor-1c (SREBP-1c) and muscle hexokinase (HK) mRNA expression that was downregulated in diabetic group. Pyruvate kinase (PK) mRNA expression was restored more significantly in VC-treated than vanadyl sulfate-treated diabetic rats. These results indicate that the newly synthesized VC could be an effective anti-diabetic candidate as the anti-diabetic activity of the ionic vanadium was enhanced after being modified with the organic ligand, thiamin. The results also suggest that VC achieves its effect most likely through modulating the transcription of energy metabolizing enzymes. © The Author(s) 2015.

  20. Macrosomia in non-gestational diabetes pregnancy: glucose tolerance test characteristics and feto-maternal complications in tropical Asia Pacific Australia.

    Science.gov (United States)

    Aranha, Algenes; Malabu, Usman H; Vangaveti, Venkat; Reda, Elham Saleh; Tan, Yong Mong; Sangla, Kunwarjit Singh

    2014-06-01

    To look into the glucose tolerance test characteristics and determine complications in non-gestational diabetes pregnant subjects. From 2006 to 2009 all non-gestational diabetes mellitus (non-GDM) pregnant women who delivered macrosomia at the North Australia's Townsville Hospital were retrospectively reviewed by extracting data from clinical record. Glucose tolerance tests results were analysed in the light of an earlier diagnosis of non-GDM. Ninety-one non-GDM mothers with macrosomia were studied and compared with 41 normoglycemic subjects without macrosomia. Of the subjects with non-GDM macrosomia, 45 (49.4%) had normal 50 g glucose challenge test (GCT) without further testing, another 8 (8.8%) had abnormal GCT but normal 75 g oral glucose tolerance test (OGTT). A total of 4 (4.4%) subjects had normal GCT and OGTT. Interestingly, 14 out of 16 (87.5%) subjects who were tested with OGTT owing to past history of macrosomia had normal results but delivered macrosomic babies. Only 12 subjects had both GCT and OGTT, the rest of the cohort had either of the two tests. Subjects with non-GDM macrosomia had higher frequency of neonatal hypoglycaemia 34% as compared to 10% in non-macrosomic babies (P=0.003). Other feto-maternal complications were similar in both groups. No significant pattern of glucose tolerance characteristics was identified in non-GDM mothers with macrosomic babies. In spite of being normoglycemic significant neonatal hypoglycaemia was recorded in non-GDM macrosomic babies. Further prospective studies on a larger population are needed to verify our findings.

  1. Evaluation of olfaction and taste function in type 2 diabetic patients with and without peripheral neuropathy.

    Science.gov (United States)

    Yazla, Semih; Özmen, Süay; Kıyıcı, Sinem; Yıldız, Demet; Haksever, Mehmet; Gencay, Sündüz

    2017-12-12

    Olfaction and gustation in patients with diabetes mellitus have great significance on quality of life, and their impairment may result in possible hazards. A limited number of studies have been performed to determine the alteration of both gustatory and olfactory function in type 2 diabetic patients with diabetic peripheral neuropathy (DPN). The aim of this study was to determine whether type 2 diabetic patients, with and without DPN, exhibit major olfactory and gustatory dysfunction using validated and dependable techniques. An observational-analytical case-control study was conducted. Sixty patients with type 2 diabetes mellitus (T2DM) and 30 healthy control subjects with a mean age of 57.1 ± 8.4 were included in the study. Patients with T2DM were recruited from the endocrinology outpatient clinic. After clinical evaluation and electromyography examination, patients with T2DM were divided into the 2 groups, with and without DPN. After a 10-hour fasting period, blood samples were taken for the measurement of serum creatinine, lipids, and HbA1c. For the quantitative assessment of olfactory function, all participants underwent butanol threshold test and odour identification test. Gustatory function was tested administering a whole-mouth above-threshold test using sucrose solutions. The control subjects showed significantly higher Sniffin' sticks and butanol threshold scores than the diabetic patients without DPN (P = .001 and P = .009). No significant difference was found in the gustatory function test between these 2 groups (P = .116). Diabetic patients with DPN had lower Sniffin' sticks scores, butanol threshold scores, and higher sucrose thresholds compared to the controls (P diabetic patients with or without DPN regarding Sniffin' sticks scores, butanol threshold, and sucrose thresholds (P = .302, P = .181, and P = .118). In conclusion, this study demonstrates that T2DM is associated with olfactory and gustatory dysfunction. The fact that there

  2. Evaluation of cardiac sympathetic neuronal integrity in diabetic patients using iodine-123 metaiodobenzylguanidine

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Jung [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Lee, Jong Doo [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Ryu, Young Hoon [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Jeon, Pyoung [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Shim, Yong Woon [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Yoo, Hyung Sik [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Park, Chang Yun [Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of); Lim, Seung Gil [Department of Endocrinology, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752 (Korea, Republic of)

    1996-04-01

    Autonomic dysfunction is associated with increased mortality in diabetic patients. To evaluate the cardiac autonomic dysfunction in these patients, a prospective study was undertaken using iodine-123 metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET). The study groups consisted of ten diabetic patients with cardiac autonomic neuropathy (group I) and six without autonomic neuropathy (group II). Autonomic nervous function tests, thallium scan, radionuclide ventriculographic data including ejection fraction and wall motion study, and 24-h urine catecholamine levels were evaluated. {sup 123}I-MIBG SPET was performed at 30 min and 4 h following injection of 3 mCi of {sup 123}I-MIBG in groups I and II and in normal subjects (n=4). On planar images, the heart to mediastinum (H/M) ratio was measured. Defect pattern and severity of MIBG uptake were qualitatively analysed on SPET. Compared with control subjects, diabetic patients had a reduced H/M ratio regardless of the presence of clinical autonomic neuropathy. There was no difference in H/M ratio between groups I and II. On SPET images, focal or diffuse defects were demonstrated in all patients in group I, and in five of the six patients in group II. The extent of defects tended to be more pronounced in group I than in group II. In conclusion, {sup 123}I-MIBG scan was found to be a more sensitive method than clinical autonomic nervous function tests for the detection of autonomic neuropathy in diabetes. (orig.). With 3 figs., 1 tab.

  3. Duplex Color Doppler Evaluation of Retinal Arterial Blood Flow in Type 2 Diabetic Subjects without Retinopathy

    Directory of Open Access Journals (Sweden)

    Mashah Binte Amin

    2014-09-01

    Full Text Available Background: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathy is diagnosed early and treated promptly. In ophthalmology, color Doppler imaging is a new method that enables us to assess the orbital vasculature. It allows for simultaneous two dimensional anatomical and Doppler evaluations of hemodynamic characteristics of retinal artery. Objective: To observe the difference between Doppler flow velocity indices (peak systolic velocity, end diastolic velocity and resistive index of retinal artery in type 2 diabetic subjects without retinopathy and those of normal controls. Materials and Methods: This case-control study was carried out in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM in collaboration with Ophthalmology Outpatient Department, BIRDEM, Dhaka from July 2011 to June 2013. Eighty diabetic patients without retinopathy aged 27–68 years were enrolled as cases and age and sex matched 80 healthy subjects were selected as controls. Type 1 diabetic patients, type 2 diabetics with retinopathy, hypertensive and dyslipidemic subjects were excluded from the study. All the selected subjects underwent duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHZ linear phase transducer. Duplex color Doppler findings including spectral analysis (PSV, EDV and RI were recorded. Unpaired t test was done to compare blood flow velocity indices of retinal artery in type 2 diabetic patients without retinopathy and that of healthy control subjects. p value <0.05 was considered as significant. Results: Majority (42.5% and 47.5% of subjects were in 4th decade of life in both groups with predominance of males. The mean duration of diabetes was 4.56 ± 2.1 years. Mean peak systolic

  4. Huntington Disease in Asia

    Directory of Open Access Journals (Sweden)

    Miao Xu

    2015-01-01

    Conclusions: The lower epidemiology in Asians can be partly explained by the less cytosine-adenine-guanine repeats, different haplotypes, and CCG polymorphisms. For the physicians, atypical clinical profiles such as the initial symptom of ataxia, movement abnormalities of Parkinsonism, dystonia, or tics need to be paid more attention to and suggest gene testing if necessary. Moreover, some pathogenesis studies may help progress some new advanced treatments. The clinicians in Asian especially in China should promote the usage of genetic testing and put more effects in rehabilitation, palliative care, and offer comfort of patients and their families. The unified HD rating scale also needs to be popularized in Asia to assist in evaluating the progression of HD.

  5. Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy

    NARCIS (Netherlands)

    Adhien, P.; van Dijk, L.; de Vegter, M.; Westein, M.; Nijpels, G.; Hugtenburg, J.G.

    2013-01-01

    Background Interventions aimed to increase adherence to drug treatment usually are not tailored to the needs of individual patients. A modular pharmacy intervention, named 'Support for Diabetes', was developed to improve adherence to type 2 diabetes treatment. Objective To evaluate the

  6. Developing an objective evaluation method to estimate diabetes risk in community-based settings.

    Science.gov (United States)

    Kenya, Sonjia; He, Qing; Fullilove, Robert; Kotler, Donald P

    2011-05-01

    Exercise interventions often aim to affect abdominal obesity and glucose tolerance, two significant risk factors for type 2 diabetes. Because of limited financial and clinical resources in community and university-based environments, intervention effects are often measured with interviews or questionnaires and correlated with weight loss or body fat indicated by body bioimpedence analysis (BIA). However, self-reported assessments are subject to high levels of bias and low levels of reliability. Because obesity and body fat are correlated with diabetes at different levels in various ethnic groups, data reflecting changes in weight or fat do not necessarily indicate changes in diabetes risk. To determine how exercise interventions affect diabetes risk in community and university-based settings, improved evaluation methods are warranted. We compared a noninvasive, objective measurement technique--regional BIA--with whole-body BIA for its ability to assess abdominal obesity and predict glucose tolerance in 39 women. To determine regional BIA's utility in predicting glucose, we tested the association between the regional BIA method and blood glucose levels. Regional BIA estimates of abdominal fat area were significantly correlated (r = 0.554, P < 0.003) with fasting glucose. When waist circumference and family history of diabetes were added to abdominal fat in multiple regression models, the association with glucose increased further (r = 0.701, P < 0.001). Regional BIA estimates of abdominal fat may predict fasting glucose better than whole-body BIA as well as provide an objective assessment of changes in diabetes risk achieved through physical activity interventions in community settings.

  7. Evaluation of low level laser therapy in reducing diabetic polyneuropathy related pain and sensorimotor disorders.

    Science.gov (United States)

    Bashiri, Homayoon

    2013-09-09

    Over the past three decades physicians have used light level laser therapy (LLLT) for the management and the treatment of diabetic peripheral neuropathy and have obtained results that calls for further investigations. This study aimed to investigate the effectiveness of LLLT in treatment of pain symptoms in patients with diabetic polyneuropathy. In this study 60 patients with diabetic peripheral neuropathy were matched based on their sex, age, BMI, type of diabetes, duration of diabetes, and duration of pain, and randomized to case and control groups based on their established scores on the visual analog scale (VAS) and the Toronto clinical scoring system (TCSS). Cases received laser therapy with wavelength of 78 nm and 2.5 j/cm2 two times a week, each time for 5 min, for one month. During the same period, controls received sham laser therapy. Comparing the differences between the two groups' VAS and TCSS mean scores before the intervention with that of the 2 weeks and 4 weeks after the intervention we were able to see a statistically significant difference between the two groups (P<0.05). On the other hand, when we compared their VAS and TCSS mean scores 4 weeks and 2 weeks after the intervention we did not find any statistically significant difference between the two groups. We achieved the same results when we examined cases' and controls' pre and post VAS and TCSS scores independent from each other; no improvement in the assessment based on their 2 and 4 weeks comparisons tests. Laser therapy resulted in improved neuropathy outcomes in diabetic patients who received it relative to the group that received sham therapy, evaluating before and after LLLT assessments. Further studies are needed to test types of lasers, as well as different dosage and exposure levels required in different phase of neuropathic care, so as to obtain reproducible results.

  8. Qualitative evaluation of a diabetes electronic decision support tool: views of users

    Directory of Open Access Journals (Sweden)

    Wan Qing

    2012-07-01

    Full Text Available Abstract Background Quality care of type 2 diabetes is complex and requires systematic use of clinical data to monitor care processes and outcomes. An electronic decision support (EDS tool for the management of type 2 diabetes in primary care was developed by the Australian Pharmaceutical Alliance. The aim of this qualitative study was to evaluate the uptake and use of the EDS tool as well as to describe the impact of the EDS tool on the primary care consultation for diabetes from the perspectives of general practitioners and practice nurses. Methods This was a qualitative study of telephone interviews. General Practitioners and Practice Nurses from four Divisions of General Practice who had used the EDS tool for a minimum of six weeks were invited to participate. Semi-structured interviews were conducted and the interview transcripts were coded and thematically analysed using NVivo 8 software. Results In total 15 General Practitioners and 2 Practice Nurses completed the interviews. The most commonly used feature of the EDS tool was the summary side bar; its major function was to provide an overview of clinical information and a prompt or reminder to diabetes care. It also assisted communication and served an educational role as a visual aide in the consultation. Some participants thought the tool resulted in longer consultations. There were a range of barriers to use related to the design and functionality of the tool and to the primary care context. Conclusions The EDS tool shows promise as a way of summarising information about patients’ diabetes state, reminder of required diabetes care and an aide to patient education.

  9. Comparative sonographic evaluation of the anteroposterior dimensions of the pancreas in diabetics and nondiabetics.

    Science.gov (United States)

    Agabi, J O; Akhigbe, A O

    2016-01-01

    The pancreas is an insulin-producing gland and is prone to varying degrees of destruction and change in patients with diabetes mellitus (DM). Various morphological changes including reduction in the pancreas dimensions have been described in DM. To determine pancreatic anteroposterior (AP) dimensions in diabetics by sonography and compare with nondiabetics. To also evaluate the correlation of the AP dimensions with patient's anthropometry, as well as the duration of the disease in comparison with nondiabetics. This is a comparative cross-sectional study involving 150 diabetics with 150 sex and age matched healthy normoglycemic group used as controls. Sonographic measurements of the AP dimensions of the pancreatic head, body, and tail of both study groups were performed with the use of 3.5 MHz curvilinear array transducer of a SonoAce X4 ultrasound machine. Data were analyzed using Statistical Package for Social Sciences version 17 (SPSS Inc., Chicago, IL, USA). A statistical test was considered significant at P ≤ 0.05 and 95% confidence interval. Pancreas AP dimensions were significantly smaller in diabetics compared to those of the controls. The mean dimensions were 1.91 ± 0.26 cm, 0.95 ± 0.12 cm, and 0.91 ± 0.11 cm for the head, body, and tail, respectively, in diabetics and 2.32 ± 0.22 cm, 1.43 ± 0.19 cm, and 1.34 ± 0.20 cm in the control (P pancreas body and tail dimensions, while pancreas head dimension was not significantly affected by the duration of illness. Diabetics have smaller pancreas AP dimensions compared to the normal population.

  10. Within-trial economic evaluation of diabetes-specific cognitive behaviour therapy in patients with type 2 diabetes and subthreshold depression

    Directory of Open Access Journals (Sweden)

    Ohmann Christian

    2010-10-01

    Full Text Available Abstract Background Despite the high prevalence of subthreshold depression in patients with type 2 diabetes, evidence on cost-effectiveness of different therapy options for these patients is currently lacking. Methods/Design Within-trial economic evaluation of the diabetes-specific cognitive behaviour therapy for subthreshold depression. Patients with diabetes and subthreshold depression are randomly assigned to either 2 weeks of diabetes-specific cognitive behaviour group therapy (n = 104 or to standard diabetes education programme only (n = 104. Patients are followed for 12 months. During this period data on total health sector costs, patient costs and societal productivity costs are collected in addition to clinical data. Health related quality of life (the SF-36 and the EQ-5D is measured at baseline, immediately after the intervention, at 6 and at 12 months after the intervention. Quality adjusted life years (QALYs, and cumulative costs will be estimated for each arm of the trial. Cost-effectiveness of the diabetes-specific cognitive behaviour group therapy will be analysed from the perspective of the German statutory health insurance and from the societal perspective. To this end, incremental cost-effectiveness ratio (ICER in terms of cost per QALY gained will be calculated. Discussion Some methodological issues of the described economic evaluation are discussed. Trial registration The trial has been registered at the Clinical Trials Register (NCT01009138.

  11. Apparel in South Asia

    OpenAIRE

    Lopez-Acevedo, Gladys; Robertson, Raymond

    2016-01-01

    Apparel is the largest labor-intensive manufacturing industry in South Asia, and is a major employer of women. Although South Asia’s apparel sector benefits from many of the same favorable conditions as East Asia’s, performance in South Asian apparel remains well below that of East Asia. The objective of this study is to identify the policy changes necessary for South Asia to capitalize on...

  12. Evaluation of four portable blood glucose meters in diabetic and non-diabetic dogs and cats.

    Science.gov (United States)

    Kang, Min-Hee; Kim, Do-Hyung; Jeong, In-Seong; Choi, Gab-Chol; Park, Hee-Myung

    2016-01-01

    Monitoring of an animal's blood glucose concentration is critical for diagnostic and therapeutic decisions. Over the past few decades, portable blood glucose meters (PBGMs) have been used to monitor blood glucose concentrations in animals. Recently, new and improved PBGMs have been made available on the market. The purpose of this study was to evaluate four PBGMs for use in dogs and cats. A total of 155 venous blood samples of dogs and 85 venous blood samples of cats were tested using four PBGMs. Control solutions from manufacturers were used to determine the precision of each meter. The coefficient of variation was calculated to determine precision during a set of replicates. Pearson's correlation analysis, Passing-Bablok regression, and Bland-Altman analysis were used to determine the accuracy of four PBGMs against the hexokinase reference method. Error grid analysis was used to evaluate clinical relevance. All PBGMs, except CERA-PET®, were clinically acceptable for monitoring blood glucose concentrations; AlphaTrak® and VetMate® appeared to be the most accurate ones, demonstrating that to use PBGMs for glucose monitoring, it is important to understand the strengths or limitations of each meter. The difference in results between the PBGMs and the reference method increased at high glucose concentration ranges, which were also affected by the hematocrit. Although readings of the PBGMs and the reference method varied across glycemic ranges (low, normal, and high glucose concentrations), most PBGMs were clinically acceptable for monitoring blood glucose concentrations in dogs and cats.

  13. Southeast Asia's changing palaeogeography

    National Research Council Canada - National Science Library

    Hall, R

    2009-01-01

    Geology provides the basis for understanding distributions of faunas and floras in Southeast Asia but only via a complex interplay of plate movements, palaeogeography, ocean circulation and climate...

  14. Economic evaluation of chronic disease self-management for people with diabetes: a systematic review.

    Science.gov (United States)

    Teljeur, C; Moran, P S; Walshe, S; Smith, S M; Cianci, F; Murphy, L; Harrington, P; Ryan, M

    2017-08-01

    To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA 1c levels in people with diabetes. Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review. The target population was adults with diabetes. Interventions had to have a substantial component of self-management support and be compared with routine care. Study quality was evaluated using the Consensus on Health Economic Criteria and International Society of Pharmacoeconomic Outcomes Research questionnaires. A narrative review approach was used. A total of 16 costing and 21 cost-effectiveness studies of a range of self-management support interventions were identified. There was reasonably consistent evidence across 22 studies evaluating education self-management support programmes suggesting these interventions are cost-effective or superior to usual care. Telemedicine-type interventions were more expensive than usual care and potentially not cost-effective. There was insufficient evidence regarding the other types of self-management interventions, including pharmacist-led and behavioural interventions. The identified studies were predominantly of poor quality, with outcomes based on short-term follow-up data and study designs at high risk of bias. Self-management support education programmes may be cost-effective. There was limited evidence regarding other formats of self-management support interventions. The poor quality of many of the studies undermines the evidence base regarding the economic efficiency of self-management support interventions for people with diabetes. © 2016 Diabetes UK.

  15. Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook.

    Science.gov (United States)

    Greene, Jeremy A; Choudhry, Niteesh K; Kilabuk, Elaine; Shrank, William H

    2011-03-01

    Several disease-specific information exchanges now exist on Facebook and other online social networking sites. These new sources of knowledge, support, and engagement have become important for patients living with chronic disease, yet the quality and content of the information provided in these digital arenas are poorly understood. To qualitatively evaluate the content of communication in Facebook communities dedicated to diabetes. We identified the 15 largest Facebook groups focused on diabetes management. For each group, we downloaded the 15 most recent "wall posts" and the 15 most recent discussion topics from the 10 largest groups. Four hundred eighty unique users were identified in a series of 690 comments from wall posts and discussion topics. Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a thematic coding scheme, and applied codes to the data. Patients with diabetes, family members, and their friends use Facebook to share personal clinical information, to request disease-specific guidance and feedback, and to receive emotional support. Approximately two-thirds of posts included unsolicited sharing of diabetes management strategies, over 13% of posts provided specific feedback to information requested by other users, and almost 29% of posts featured an effort by the poster to provide emotional support to others as members of a community. Approximately 27% of posts featured some type of promotional activity, generally presented as testimonials advertising non-FDA approved, "natural" products. Clinically inaccurate recommendations were infrequent, but were usually associated with promotion of a specific product or service. Thirteen percent of posts contained requests for personal information from Facebook participants. Facebook provides a forum for reporting personal experiences, asking questions, and receiving direct feedback for people living with diabetes. However, promotional activity and personal

  16. Evaluation of a program to improve diabetes care through intensified care management activities and diabetes medication copayment reduction.

    Science.gov (United States)

    Kogut, Stephen J; Johnson, Scott; Higgins, Tara; Quilliam, Brian

    2012-05-01

    Medication copayment reduction can be integrated with disease management programs to incentivize patient engagement in chronic care management. While disease management programs in diabetes have been evaluated across a range of settings and designs, less is known regarding the effectiveness of copayment reduction as a component of disease management. To evaluate the short-term results of a diabetes-focused disease management program that included copayment reduction, care coordination, and patient goal setting, focusing on rates of evidence-based care processes and all-cause pharmacy and health care costs. Blue Cross Blue Shield of Rhode Island offered large employer groups the opportunity to participate in a diabetes disease management initiative that featured reduced copayments (from $7/$25/$40 for generic, tier 2, and tier 3 drugs, respectively, to $0 for generic and $0-$2 for brand drugs) for diabetes-related medications. In return for the copayment reduction, participants agreed to the following: (a) participate in care coordination with a case manager, (b) have an annual physical examination, (c) have a hemoglobin A1c blood test at least twice annually, and (d) have a low-density lipoprotein cholesterol (LDL-C) test at least once annually. Patients received personalized support provided by a registered nurse and dietician, disease-related education provided by nurses, and intensified case management services, including working with a health coach to establish healthy behavioral change goals. All study subjects were aged 18 years or older and had at least 1 ICD-9-CM code for diabetes and at least 1 claim for an antidiabetic drug during a 12-month measurement period, which was each subject's most recent 12-month period of continuous enrollment from January 1, 2008, through May 31, 2010. Administrative claims data were used to determine the percentage of intervention (participating) and nonintervention (nonparticipating) subjects from among all of the plan

  17. Evaluation of adherence to international guidelines for treating patients with type 2 diabetes mellitus in Kuwait.

    Science.gov (United States)

    Al-Taweel, Dalal M; Awad, Abdelmoneim I; Johnson, B Julienne

    2013-04-01

    Clinical guidelines derived from scientific evidence provide the basis of consistent standardized prescribing. Despite an alarming increase of diabetes in Kuwait, no studies related to the quality of prescribing in diabetes were found. Before pharmaceutical care can be implemented to improve the quality of care of patients with diabetes, it is important to determine whether prescribers are compliant with comprehensive international guidelines for cardioprevention and glycaemic control. To evaluate the adherence to clinical guidelines for treating patients with type 2 diabetes mellitus in primary care centres and secondary care centres (hospitals) using a developed and validated medication assessment tool with reference to international guidelines. Outpatient diabetes clinics in 8 primary care centres and 4 secondary care centres across four healthcare regions in Kuwait. A quantitative, cross-sectional study involving a sample of 652 Kuwaiti patients with type 2 diabetes, who were selected using systematic sampling from the study settings. Data were collected retrospectively from the patients' medical records using a validated 43-criterion medication assessment tool (MATKW) designed to assess cardioprevention and treatment in patients with type 2 diabetes. Descriptive and comparative analysis was conducted using SPSS version 17. Frequency of prescribing adherence to agreed definitions of criteria derived from international guidelines. Overall adherence to prescribing diabetes guidelines was 77.7 % (95 % CI 76.7-78.6 %). Significantly higher prescribing adherence was found in the secondary care facilities, 82.4 % (95 % CI 81.2-83.6 %) compared to primary care 72.5 % (95 % CI 71.0-73.9 %) (p adherence >80 % in secondary care compared to ten criteria in primary care. The documentation of patients' records was found to be inconsistent at the study healthcare facilities. Nonoptimal achievement of target goals for HbA1c, blood pressure and BMI was prevalent among the

  18. EVALUATION OF AIRWAY AND PREDICTING DIFFICULT ENDOTRACHEAL INTUBATION IN DIABETIC PATIENTS- A COMPARISON WITH NONDIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Sachin Ramesh Gondane

    2017-01-01

    Full Text Available BACKGROUND The aim of this study is to evaluate the various clinical parameters of airway assessment and their ability to predict difficult laryngoscopy and intubation in diabetic patients as compared to nondiabetic patients. MATERIALS AND METHODS Out of 120 patients, 60 diabetics (group-D and 60 nondiabetics (group-N were studied preoperatively for various airway indices such as the modified Mallampati Test (MPC, Thyromental Distance (TMD, Degree of Head Extension (HE, the Palm Print Index (PP and the Prayer Sign (PS and their corresponding Cormack-Lehane scores (CL were noted. The two groups were studied using chi-square tests. p<0.05 was considered statistically significant. RESULTS The incidence of difficult laryngoscopy as indicated by CL grade III and IV in diabetic patients was 43.33%, while that in the nondiabetic group was 20%. In diabetics group, MPC as a predictor was more sensitive (80.77% while PP index was more specific (97.06%. PP index also had maximum positive predictive value and odds ratio. In nondiabetic group, MPC had maximum sensitivity (75.00% while PP index, PS and TMD were showed equal specificity (95.83%. CONCLUSION MPC as a predictor was more sensitive in both groups while PP index was more specific in group D.

  19. Development, Technical, and User Evaluation of a Web Mobile Application for Self-Control of Diabetes.

    Science.gov (United States)

    Garcia-Zapirain, Begoña; de la Torre Díez, Isabel; Sainz de Abajo, Beatriz; López-Coronado, Miguel

    2016-09-01

    The main objective of this research was to develop and evaluate a Web-based mobile application (app) known as "Diario Diabetes" on both a technical and user level, by means of which individuals with diabetes may monitor their illness easily at any time and in any place using any device that has Internet access. The technologies used to develop the app were HTML, CSS, JavaScript, PHP, and MySQL, all of which are an open source. Once the app was developed, it was evaluated on a technical level (by measuring loading times) and on a user level, through a survey. Different loading times for the application were measured, with it being noted that under no circumstances does this exceed 2 s. Usability was evaluated by 150 users who initially used the application. A majority (71%) of users used a PC to access the app, 83% considered the app's design to be attractive, 67% considered the tasks to be very useful, and 67% found it very easy to use. Although applications exist for controlling diabetes both at mobile virtual shops or on a research level, our app may help to improve the administration of these types of patients and they are the ones who will ultimately opt for one or the other. According to the results obtained, we can state that all users would recommend the app's use to other users.

  20. [Evaluation of fructosamine as a parameter of blood glucose control in diabetic pregnant women].

    Science.gov (United States)

    Feitosa, Alina Coutinho Rodrigues; Andrade, Flávio Silva

    2014-10-01

    To evaluate the alternative parameters to monitor glycemia in pregnant women with diabetes studying the relationship between fructosamine testing and self monitoring of blood glucose in pregnant women with diabetes. Serum fructosamine levels and the self monitoring of blood glucose over 14 days before the collection of fructosamine were evaluated in 47 diabetic pregnant women. Seventy-one fructosamine levels and 2,238 glucose measurements (CGs) were analysed. Levels of fructosamine correlated with high blood glucose index (HBGI) and the standard deviation of glycemias (r = 0.28; p = 0.021 and r = 0.26; p = 0.03, respectively). The comparison between the mothers of the newborns with appropriated or large birthweight and those who gave birth to small newborns for their gestational age (SGA) showed that the latter had a lower glycemic mean (105 vs. 114 and 119 mg/dL), a higher low blood glucose index (5.8 vs. 1.3 and 0.7) and a higher percentage of hyperglycemias (11 vs. 0 and 0%) even when the fructosamine falls within the reference values (242 vs. 218 and 213 μmol/l). The levels of fructosamine can be used as further parameter to aid self monitoring of blood glucose to evaluate hyperglycemias and glycemic variability, however, this can underestimate hypoglycemias in pregnant women carrying small-for-gestational age fetuses.

  1. Archipelago colonization by ecologically dissimilar amphibians: evaluating the expectation of common evolutionary history of geographical diffusion in co-distributed rainforest tree frogs in islands of Southeast Asia.

    Science.gov (United States)

    Gonzalez, Paulette; Su, Yong-Chao; Siler, Cameron D; Barley, Anthony J; Sanguila, Marites B; Diesmos, Arvin C; Brown, Rafe M

    2014-03-01

    Widespread, co-distributed species with limited relative dispersal abilities represent compelling focal taxa for comparative phylogeography. Forest vertebrates in island archipelagos often exhibit pronounced population structure resulting from limited dispersal abilities or capacity to overcome marine barriers to dispersal. The exceptionally diverse Old World tree frogs of the family Rhacophoridae have colonized the forested island archipelagos of Southeast Asia on multiple occasions, entering the islands of Indonesia and the Philippines via a "stepping stone" mode of dispersal along elongate island chains, separated by a series of marine channels. Here we evaluate the prediction that two tightly co-distributed Philippine rhacophorids colonized the archipelago during concomitant timescales and in the same, linear, "island-hopping" progression. We use a new multilocus dataset, utilize dense genetic sampling from the eastern arc of the Philippines, and we take a model-based phylogeographic approach to examining the two species for similar topological patterns of diversification, genetic structure, and timescales of diversification. Our results support some common mechanistic predictions (a general south-to-north polarity of colonization) but not others (timescale for colonization and manner and degree of lineage diversification), suggesting differing biogeographic scenarios of geographical diffusion through the archipelago and unique and idiosyncratic ecological capacities and evolutionary histories of each species. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Monitoring of psychological well-being in outpatients with diabetes: effects on mood, HbA(1c), and the patient's evaluation of the quality of diabetes care: a randomized controlled trial

    NARCIS (Netherlands)

    Pouwer, F.; Snoek, F. J.; van der Ploeg, H. M.; Adèr, H. J.; Heine, R. J.

    2001-01-01

    To investigate whether monitoring and discussing psychological well-being in outpatients with diabetes improves mood, glycemic control, and the patient's evaluation of the quality of diabetes care. This study was a randomized controlled trial of 461 outpatients with diabetes who were randomly

  3. Evaluation of Cross-Correlation Methods on a Massive Scale for Accurate Relocation of Seismic Events in East Asia

    Science.gov (United States)

    2006-04-21

    This is likely because of the deviation of the true crustal structure from the IASP91 model in the source area, a region of thick lithosphere . The effect...evaluate the stability of the double-difference solutions. In addition to the regional models listed in Table 3, a standard crustal model is used (IASP9 1...mantle velocity of vp = 8.04 km/s. Figure 7 compares, for each cluster, the locations of reference events obtained with the regional model ( thick black

  4. Safety evaluation studies of Citrullus colocynthis for diabetes in rats

    Directory of Open Access Journals (Sweden)

    S.K Atole

    Full Text Available An experiment conducted in the department of Pharmacology and Toxicology, Nagpur Veterinary College, Nagpur reported Citrullus colocynthis to posses antidiabetic effect in rats at the rate of 50 mg/kg b.w and 100mg/kg b.w. So it was decided to also evaluate the safety of Citrullus colocynthis in rats at its antidiabetic dose. The experiment was conducted for 28 days .18 wistar rats were divided into three groups containing six rats in each group. Group T1 was maintained as normal control, whereas groups T2 and T3 received aqueous extract of Citrullus colocynthis @ 50 and 100 mg/kg body weight. Haematological and Biochemical estimations were done at the end of experiment i.e. on 29th day by using standard kits. Rats were then sacrificed and histopathological examinations were done. The results obtained showed that Citrullus colocynthis is safe at its antidiabetic dose and is safe for use as an antidiabetic remedy. [Vet World 2009; 2(11.000: 423-425

  5. Dose-ranging evaluation of intravitreal siRNA PF-04523655 for diabetic macular edema (the DEGAS study)

    DEFF Research Database (Denmark)

    Nguyen, Quan Dong; Schachar, Ronald A; Nduaka, Chudy I

    2012-01-01

    To evaluate the safety and efficacy of three doses of PF-04523655, a 19-nucleotide methylated double stranded siRNA targeting the RTP801 gene, for the treatment of diabetic macular edema (DME) compared to focal/grid laser photocoagulation.......To evaluate the safety and efficacy of three doses of PF-04523655, a 19-nucleotide methylated double stranded siRNA targeting the RTP801 gene, for the treatment of diabetic macular edema (DME) compared to focal/grid laser photocoagulation....

  6. Evaluation of oral health knowledge, attitude, and practices among diabetics in a Northern Union Territory of India

    Directory of Open Access Journals (Sweden)

    Shipra Gupta

    2017-01-01

    Full Text Available Background: Periodontal disease has been labeled as the “sixth” complication of diabetes. The two diseases have a bidirectional adverse relationship to each other. Diabetes can aggravate periodontitis, and periodontitis can negatively affect the glycemic control of diabetics. Oral hygiene awareness and treatment of periodontal diseases play an important part not only in prevention of many complications due to diabetes but also decrease the morbidity due to these manifestations. Aim: The goal of this cross-sectional study was to determine the actual awareness of diabetic patients about their oral health and the oral hygiene measures being practiced by them. Another aim was to evaluate their knowledge regarding the impact of oral health on glycemic control. It was also assessed whether there was any significant difference in the oral health awareness levels with their nondiabetic counterparts. Materials and Methods: One hundred diabetic and one hundred nondiabetic respondents filled up a validated questionnaire which comprised questions on personal data, oral hygiene knowledge, attitude, oral hygiene practices, and their knowledge regarding the correlation of oral health to adverse glycemic control and vice versa. Data were compiled and subjected to statistical analysis. Results: The results indicate no statistically significant differences in the variables assessed in both the groups, indicating that no further knowledge had been imparted to the diabetics after they were detected with the disease. Seventy-three percent of nondiabetics and 76% of diabetics were unaware of the relationship between oral health and diabetes. Conclusion: The study concludes that both diabetics and nondiabetics lack awareness of the relationships between diabetes and oral health. To provide better oral health care, more knowledge needs to be made available to the diabetic patients and the medical community.

  7. AED in Asia

    Science.gov (United States)

    Academy for Educational Development, 2004

    2004-01-01

    Founded in 1961, the Academy for Educational Development (AED) is an independent, nonprofit, charitable organization that operates development programs in the United States and throughout the world. This directory presents an overview of AED endeavors in Asia. AED's work in Asia has centered on institution-building, taking advantage of its…

  8. Evaluating Diabetes Care for Patients With Serious Mental Illness Using the Chronic Care Model

    Directory of Open Access Journals (Sweden)

    Kelly Vaez

    2017-10-01

    Full Text Available People with serious mental illness (SMI have a higher incidence of type 2 diabetes mellitus (T2DM and shorter life span due to medical health problems. The chronic care model (CCM has been used to improve care of patients with T2DM. One clinical organization that provided primary care to patients with SMI had excellent diabetes outcomes but did not have information on how they achieved those outcomes. Thus, we conducted a pilot study chart review for 30 patients with T2DM and SMI to determine how well the clinic’s system aligned with the overall CCM components and which components correlated with diabetes control. We also evaluated use of the CCM using the Assessment of Chronic Illness Care provider survey. Results showed that the clinic had an overall basic implementation level of the CCM, which allows opportunity for improvement. Two elements of the CCM were correlated with hemoglobin A 1C and both were in an unexpected direction: self-management support in the variable of percentage of visits that included patient-specific goal-setting ( r s = .52; P = .004 and delivery system design in the variable of number of nurse practitioner visits per study period ( r s = .43; P = .02. These findings suggest that the clinic may have made more concentrated efforts to manage diabetes for patients who were not in good diabetes control. Providers noted the influence of SMI and social service organization support on these patients’ clinical outcomes. The findings will be reexamined after a fuller implementation of the CCM to further improve management in this population.

  9. Evaluation of fiber intake in diabetes 2 patients of an asistencial center of Rosario city

    Directory of Open Access Journals (Sweden)

    María Elisa Zapata

    2013-09-01

    Full Text Available Introduction: a diet high in fiber has associated with better glycaemic control in diabetes 2 patients, being the soluble fraction of the most effective in the control of blood sugar levels. The aim of the study is determine the amount of total, soluble and insoluble dietary fiber intake by patients with type 2 diabetes who attended a medical centre for diabetics in Rosario.Material and methods: descriptive, observational, cross-sectional study was conducted. It was determined a sample of 60 adults with a diagnosis of diabetes type 2 >6 months, 18 to 70 years old, with no disease or intestinal disorders. A semiquantitative food frequency questionnaire of foods source of dietary fiber, and a photo album was used to identify the portion size. Descriptive statistical analysis was performed and Chi-square and ANOVA test was used to evaluate the association.Results: the average consumption of total fiber was 18,8±5,9 g/d, 14, 8±4,6 g/d corresponded to insoluble fiber and 4,0±1,5 g/d to soluble fiber. Fruits and vegetables contributed 82% of soluble fiber. Most patients (62% had a consumption of fiber total less than the recommendation of the ADA, and 60% presented an inadequate relationship between intake of soluble and insoluble fiber.Conclusions: it is necessary to increase the contribution of total dietary fiber, especially the soluble fraction in diabetes 2 patients, because there are evidences that supports its benefits.

  10. The DISC (Diabetes in Social Context Study-evaluation of a culturally sensitive social network intervention for diabetic patients in lower socioeconomic groups: a study protocol

    Directory of Open Access Journals (Sweden)

    Vissenberg Charlotte

    2012-03-01

    Full Text Available Abstract Background Compared to those in higher socioeconomic groups, diabetic patients in lower socioeconomic groups have less favourable metabolic control and experience more diabetes-related complications. They encounter specific barriers that hinder optimal diabetes self-management, including a lack of social support and other psychosocial mechanisms in their immediate social environments. Powerful Together with Diabetes is a culturally sensitive social network intervention specifically targeted to ethnic Dutch, Moroccan, Turkish, and Surinamese diabetic patients in lower socioeconomic groups. For ten months, patients will participate in peer support groups in which they will share experiences, support each other in maintaining healthy lifestyles, and learn skills to resist social pressure. At the same time, their significant others will also receive an intervention, aimed at maximizing support for and minimizing the negative social influences on diabetes self-management. This study aims to test the effectiveness of Powerful Together with Diabetes. Methods/Design We will use a quasi-experimental design with an intervention group (Group 1 and two comparison groups (Groups 2 and 3, N = 128 in each group. Group 1 will receive Powerful Together with Diabetes. Group 2 will receive Know your Sugar, a six-week group intervention that does not focus on the participants' social environments. Group 3 receives standard care only. Participants in Groups 1 and 2 will be interviewed and physically examined at baseline, 3, 10, and 16 months. We will compare their haemoglobin A1C levels with the haemoglobin A1C levels of Group 3. Main outcome measures are haemoglobin A1C, diabetes-related quality of life, diabetes self-management, health-related, and intermediate outcome measures. We will conduct a process evaluation and a qualitative study to gain more insights into the intervention fidelity, feasibility, and changes in the psychosocial mechanism in the

  11. Economic evaluation of a diabetes disease management programme with a central role for the diabetes nurse specialist

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Bruijsten, M.W.A.M.; Vrijhoef, H.J.M.

    2007-01-01

    Background: In the region of Maastricht, The Netherlands, a disease management programme (DMP) for patients with diabetes mellitus was implemented. The programme aims to improve quality of care within existing budgets. To achieve this, diabetes nurse specialists (DNSs) were given a central role

  12. Multi-year application of WRF-CAM5 over East Asia-Part I: Comprehensive evaluation and formation regimes of O3 and PM2.5

    Science.gov (United States)

    He, Jian; Zhang, Yang; Wang, Kai; Chen, Ying; Leung, L. Ruby; Fan, Jiwen; Li, Meng; Zheng, Bo; Zhang, Qiang; Duan, Fengkui; He, Kebin

    2017-09-01

    Accurate simulations of air quality and climate require robust model parameterizations on regional and global scales. The Weather Research and Forecasting model with Chemistry version 3.4.1 has been coupled with physics packages from the Community Atmosphere Model version 5 (CAM5) (WRF-CAM5) to assess the robustness of the CAM5 physics package for regional modeling at higher grid resolutions than typical grid resolutions used in global modeling. In this two-part study, Part I describes the application and evaluation of WRF-CAM5 over East Asia at a horizontal resolution of 36-km for six years: 2001, 2005, 2006, 2008, 2010, and 2011. The simulations are evaluated comprehensively with a variety of datasets from surface networks, satellites, and aircraft. The results show that meteorology is relatively well simulated by WRF-CAM5. However, cloud variables are largely or moderately underpredicted, indicating uncertainties in the model treatments of dynamics, thermodynamics, and microphysics of clouds/ices as well as aerosol-cloud interactions. For chemical predictions, the tropospheric column abundances of CO, NO2, and O3 are well simulated, but those of SO2 and HCHO are moderately overpredicted, and the column HCHO/NO2 indicator is underpredicted. Large biases exist in the surface concentrations of CO, NOx, and PM10 due to uncertainties in the emissions as well as vertical mixing. The underpredictions of NO lead to insufficient O3 titration, thus O3 overpredictions. The model can generally reproduce the observed O3 and PM indicators. These indicators suggest to control NOx emissions throughout the year, and VOCs emissions in summer in big cities and in winter over North China Plain, North/South Korea, and Japan to reduce surface O3, and to control SO2, NH3, and NOx throughout the year to reduce inorganic surface PM.

  13. Prioritizing action on health inequities in cities: An evaluation of Urban Health Equity Assessment and Response Tool (Urban HEART) in 15 cities from Asia and Africa.

    Science.gov (United States)

    Prasad, Amit; Kano, Megumi; Dagg, Kendra Ann-Masako; Mori, Hanako; Senkoro, Hawa Hamisi; Ardakani, Mohammad Assai; Elfeky, Samar; Good, Suvajee; Engelhardt, Katrin; Ross, Alex; Armada, Francisco

    2015-11-01

    Following the recommendations of the Commission on Social Determinants of Health (2008), the World Health Organization (WHO) developed the Urban Health Equity Assessment and Response Tool (HEART) to support local stakeholders in identifying and planning action on health inequities. The objective of this report is to analyze the experiences of cities in implementing Urban HEART in order to inform how the future development of the tool could support local stakeholders better in addressing health inequities. The study method is documentary analysis from independent evaluations and city implementation reports submitted to WHO. Independent evaluations were conducted in 2011-12 on Urban HEART piloting in 15 cities from seven countries in Asia and Africa: Indonesia, Iran, Kenya, Mongolia, Philippines, Sri Lanka, and Vietnam. Local or national health departments led Urban HEART piloting in 12 of the 15 cities. Other stakeholders commonly engaged included the city council, budget and planning departments, education sector, urban planning department, and the Mayor's office. Ten of the 12 core indicators recommended in Urban HEART were collected by at least 10 of the 15 cities. Improving access to safe water and sanitation was a priority equity-oriented intervention in 12 of the 15 cities, while unemployment was addressed in seven cities. Cities who piloted Urban HEART displayed confidence in its potential by sustaining or scaling up its use within their countries. Engagement of a wider group of stakeholders was more likely to lead to actions for improving health equity. Indicators that were collected were more likely to be acted upon. Quality of data for neighbourhoods within cities was one of the major issues. As local governments and stakeholders around the world gain greater control of decisions regarding their health, Urban HEART could prove to be a valuable tool in helping them pursue the goal of health equity. Copyright © 2015. Published by Elsevier Ltd.

  14. Multi-year application of WRF-CAM5 over East Asia-Part I: Comprehensive evaluation and formation regimes of O 3 and PM 2.5

    Energy Technology Data Exchange (ETDEWEB)

    He, Jian; Zhang, Yang; Wang, Kai; Chen, Ying; Leung, L. Ruby; Fan, Jiwen; Li, Meng; Zheng, Bo; Zhang, Qiang; Duan, Fengkui; He, Kebin

    2017-09-01

    Accurate simulations of air quality and climate require robust model parameterizations on regional and global scales. The Weather Research and Forecasting model with Chemistry version 3.4.1 has been coupled with physics packages from the Community Atmosphere Model version 5 (CAM5) (WRF-CAM5) to assess the robustness of the CAM5 physics package for regional modeling at higher grid resolutions than typical grid resolutions used in global modeling. In this two-part study, Part I describes the application and evaluation of WRF-CAM5 over East Asia at a horizontal resolution of 36-km for six years: 2001, 2005, 2006, 2008, 2010, and 2011. The simulations are evaluated comprehensively with a variety of datasets from surface networks, satellites, and aircraft. The results show that meteorology is relatively well simulated by WRF-CAM5. However, cloud variables are largely or moderately underpredicted, indicating uncertainties in the model treatments of dynamics, thermodynamics, and microphysics of clouds/ices as well as aerosol-cloud interactions. For chemical predictions, the tropospheric column abundances of CO, NO2, and O3 are well simulated, but those of SO2 and HCHO are moderately overpredicted, and the column HCHO/NO2 indicator is underpredicted. Large biases exist in the surface concentrations of CO, NO2, and PM10 due to uncertainties in the emissions as well as vertical mixing. The underpredictions of NO lead to insufficient O3 titration, thus O3 overpredictions. The model can generally reproduce the observed O3 and PM indicators. These indicators suggest to control NOx emissions throughout the year, and VOCs emissions in summer in big cities and in winter over North China Plain, North/South Korea, and Japan to reduce surface O3, and to control SO2, NH3, and NOx throughout the year to reduce inorganic surface PM.

  15. In vitro evaluation of anti-diabetic activity and cytotoxicity of chemically analysed Ocimum basilicum extracts.

    Science.gov (United States)

    Kadan, Sleman; Saad, Bashar; Sasson, Yoel; Zaid, Hilal

    2016-04-01

    The aim of this study was to evaluate the role of glucose transporter-4 (GLUT4) in the anti-diabetic effects of methanol, hexane and dichloromethane extracts of the aerial parts of Ocimum basilicum (OB) and to analyze their phytochemical composition. Phytochemical analysis of the three extracts by GC/MS using the silylation derivatization technique revealed 53 compounds, 17 of them were found for the first time in OB. Cytotoxic and anti-diabetic properties of the extracts were evaluated using L6-GLUT4myc muscle cells stably expressing myc epitope at the exofacial loop (GLUT4). No cytotoxic effects were observed in treated cells up to 0.25 mg/ml extract as measured with MTT and LDH-leakage assays. GLUT4 translocation to the plasma membrane was elevated by 3.5 and 7 folds (-/+ insulin) after treatment with OB extracts for 20 h. Our findings suggest that the observed anti-diabetic properties of OB extracts are possibly mediated in part through one or more of the 17 new identified compound. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Pharmacological Evaluation of Chrozophora tinctoria as Wound Healing Potential in Diabetic Rat’s Model

    Directory of Open Access Journals (Sweden)

    Harikesh Maurya

    2016-01-01

    Full Text Available Objective. The study was designed to evaluate pharmacological potential of hydroalcoholic leaves extract of Chrozophora tinctoria intended for wound healing in diabetic rats’ model. Methods. The method used to evaluate the pharmacological potential of hydroalcoholic leave extract was physical incision rat model. In this model, cutting of the skin and/or other tissues with a sharp blade has been made and the rapid disruption of tissue integrity with minimal collateral damage was observed shortly. Animals used in the study were divided into four groups that consist of six animals in each group. Group I serves as normal control, Group II serves as disease control, Group III was used as standard treatment (Povidone iodine 50 mg/kg b.w., and Group IV was used for test drug (C. tinctoria 50 mg/kg b.w.. Result. The hydroalcoholic leave extract of Chrozophora tinctoria has been significantly observed to heal the wound (98% in diabetic rats within 21 days, while standard drug (Povidone iodine healed the wound about 95% in the same condition. The oral dose (50 mg/kg b.w. of Chrozophora tinctoria was also found to improve the elevated blood glucose level in comparison to disease control group, which increased after the oral administration of Streptozotocin. Conclusion. The Chrozophora tinctoria has significant wound healing potential in the animal having physically damaged tissue in diabetic condition.

  17. Process and outcome evaluation of a diabetes prevention education program for community healthcare workers in Thailand.

    Science.gov (United States)

    Sranacharoenpong, Kitti; Hanning, Rhona M; Sirichakwal, Prapaisri P; Chittchang, Uraiporn

    2009-12-01

    To describe the development, process and outcome evaluation of a culturally tailored diabetes prevention education program for community healthcare workers (CHCWs) in Thailand. A tailored diabetes prevention education program was designed based on formative research and implemented with 35 CHCWs in semi-urban areas in Chiang Mai province, Thailand. Modules were delivered over eight group classes and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including videotaped lectures, readings, monthly newsletters and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing. Three-quarters of participants attended all eight classes and no participant attended fewer than six. On-line support and materials were accessed 3 to 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally-relevant and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (sd) of 56.5% (6.26) to 75.5% (6.01) (p E-learning were generally well-received and supported better knowledge scores. Ongoing access to web-based materials and expert support may help sustain learning.

  18. [Evaluation of a programme to monitor drug therapy in type-2 diabetics].

    Science.gov (United States)

    Fornos Pérez, J A; Guerra García, M M; Andrés Rodríguez, N F; Egea Ibernón, B

    2004-06-15

    To evaluate the results of pharmaceutical intervention in a programme to monitor the drug therapy of type-2 diabetics; and to assess the improvement of the indicators, glycosylated haemoglobin, basal glycaemia, lipid profile, albumin/creatinine, blood pressure, BMI, medication-related problems and adherence. Randomised clinical trial. 14 local pharmacies in the province of Pontevedra (Galicia), Spain. 126 type-2 diabetics, over 18 years old and who joined voluntarily a monitoring programme, distributed 50-50 into intervention and control groups. The main variable was HbA1c. Other variables were: clinical indicators of metabolic control (mean basal glycaemia, lipid profile), blood pressure, BMI, medication-related problems, understanding of the illness and its complications, adherence to medical treatment and to changes in life-style, and incidence of complications. Introduction and randomisation of patients. Recording of the initial status of the research variables, study and assessment stage, pharmaceutical interventions to detect and resolve any passing medication-related problems and educational activities. Referral to family doctor if his/her intervention required. Follow-up lasted 12 months with monthly scheduled visits and on-demand visits, after which the variables were assessed once more. The stages of study, evaluation, intervention and education did not occur in the control group. The study will enable the role of the chemist in achieving the objectives of controlling type-2 diabetes patients to be achieved through educational intervention and assistance in drug therapy monitoring.

  19. Evaluation of the efficacy and safety of bromocriptine QR in type 2 diabetes.

    Science.gov (United States)

    Ramteke, Karuna Balwant; Ramanand, Sunita Jaiprakash; Ramanand, Jaiprakash B; Jain, Suyog Subhas; Raparti, Girish Tulsidas; Patwardhan, Milind Hari; Murthy, Mangala; Ghanghas, Ravi G

    2011-07-01

    Diabetes mellitus is a chronic metabolic disorder of endocrinal origin with multiorgan involement. Today's physician has a lot many options to choose for treating type 2 diabetes, but does not always manages to achieve optimal glycemic control. The newer drug bromocriptine acts by novel hypothalamic circadian rhythm resetting mechanism. To evaluate the efficacy and safety of bromocriptine QR in type 2 diabetes. 105 patients according to inclusion and exclusion criteria were randomized into three groups by simple randomization. Group 1 received bromocriprine 2.4 mg once daily, group 2 received metformin 500 mg twice daily while group 3 received bromocriprine 1.6 mg daily and metformin 500 mg twice daily. Baseline measurement of fasting and postprandial blood sugar, HbA1(C) and BMI were followed up at 6(th) and 12(th) weeks. Safety evaluation was done by questioning the patient and also through routine hematological and biochemical parameters. Z test was used for analysis. Group 1 showed significant reduction in fasting and postprandial sugar and HbA(1c) at 12 weeks. While groups 2 and 3 showed even higher reduction in these parameters albeit with slightly more adverse drug events like nausea, vomiting compared to group 1. Bromocriptine QR is an effective and safe antidiabetic drug which can be employed as monotherapy or in conjuction with metformin to achieve and maintain optimal glycemic control.

  20. Clinical decision support software for diabetic foot risk stratification: development and formative evaluation.

    Science.gov (United States)

    Schoen, Deborah E; Glance, David G; Thompson, Sandra C

    2015-01-01

    Identifying people at risk of developing diabetic foot complications is a vital step in prevention programs in primary healthcare settings. Diabetic foot risk stratification systems predict foot ulceration. The aim of this study was to explore the views and experiences of potential end users during development and formative evaluations of an electronic diabetic foot risk stratification tool based on evidence-based guidelines and determine the accuracy of the tool. Formative evaluation of the risk tool occurred in five stages over an eight-month period and employed a mixed methods research design consisting of semi-structured interviews, focus group and participant observation, online survey, expert review, comparison to the Australian Guidelines and clinical testing. A total of 43 healthcare practitioners trialled the computerised clinical decision support system during development, with multiple software changes made as a result of feedback. Individual and focus group participants exposed critical design flaws. Live testing revealed risk stratification errors and functional limitations providing the basis for practical improvements. In the final product, all risk calculations and recommendations made by the clinical decision support system reflect current Australian Guidelines. Development of the computerised clinical decision support system using evidence-based guidelines can be optimised by a multidisciplinary iterative process of feedback, testing and software adaptation by experts in modern development technologies.

  1. Evaluation of an intra-institutional diabetes disease management program for the glycemic control of elderly long-term care diabetic patients.

    Science.gov (United States)

    Lubart, Emily; Segal, Refael; Wainstein, Julio; Marinov, Galina; Yarovoy, Alexandra; Leibovitz, Arthur

    2014-04-01

    Increasing numbers of nursing home elderly patients suffer from diabetes requiring individually optimized glycemic control. This is a complicated challenge because of their high comorbidity level, and heterogeneous and changing eating status varying from independent to dysphagia and enteral feeding. In order to cope with these complex needs, we developed and implemented a diabetes disease management program. The purpose of the present study was to evaluate this program. We used the point prevalence approach by checking for fasting blood glucose, glycated hemoglobin and other routine biochemical tests. Eating status was evaluated by the Functional Outcome Swallowing Scale. Details about the diabetes disease management program are given in the text. A total of 86 (36%) of the 234 patients on the study day were diabetics. Of these, 80 were eligible for the study. Their mean fasting blood glucose was 143.1 ± 60.6 mg/dL. The mean glycated hemoglobin level was 7.23 ± 1.39%. No case of hypoglycemia was detected on the examination day, or during the preceding 3 weeks. No significant difference was found among the different Functional Outcome Swallowing Scale categories. These results are within satisfactory range for this category of patients suggesting that our diabetes disease management program contributes to a better glycemic control. © 2013 Japan Geriatrics Society.

  2. Diabetes in Asians

    Directory of Open Access Journals (Sweden)

    Eun-Jung Rhee

    2015-09-01

    Full Text Available The prevalence of diabetes is increasing globally, particularly in Asia. According to the 2013 Diabetes Atlas, an estimated 366 million people are affected by diabetes worldwide; 36% of those affected live in the Western Pacific region, with a significant proportion in East Asia. The reasons for this marked increase in the prevalence of diabetes can be extrapolated from several distinct features of the Asian region. First, the two most populated countries, China and India, are located in Asia. Second, Asians have experienced extremely rapid economic growth, including rapid changes in dietary patterns, during the past decades. As a result, Asians tend to have more visceral fat within the same body mass index range compared with Westerners. In addition, increased insulin resistance relative to reduced insulin secretory function is another important feature of Asian individuals with diabetes. Young age of disease onset is also a distinctive characteristic of these patients. Moreover, changing dietary patterns, such as increased consumption of white rice and processed red meat, contributes to the deteriorated lifestyle of this region. Recent studies suggest a distinctive responsiveness to novel anti-diabetic agents in Asia; however, further research and efforts to reverse the increasing prevalence of diabetes are needed worldwide.

  3. Evaluation of the UCL diabetes self-management programme (UCL-DSMP): a randomized controlled trial.

    Science.gov (United States)

    Steed, Liz; Lankester, Jill; Barnard, Maria; Earle, Ken; Hurel, Stephen; Newman, Stanton

    2005-03-01

    Self-management has been described as the cornerstone of care for diabetes. Many self-management studies are limited by poor methodology and poor descriptions of the intervention. The current study developed a theoretically based self-management programme for patients with type 2 diabetes, which was evaluated via a randomized controlled trial. At immediate post-intervention and three-month follow-up the intervention group showed significant improvement relative to controls on self-management behaviours, quality of life and illness beliefs. A trend towards improved HbA1c was also observed. Documentation in a manual and development of a training programme for facilitators ensures the programme is replicable.

  4. Evaluation of islets derived from human fetal pancreatic progenitor cells in diabetes treatment.

    Science.gov (United States)

    Zhang, Wen-Jian; Xu, Shi-Qing; Cai, Han-Qing; Men, Xiu-Li; Wang, Zai; Lin, Hua; Chen, Li; Jiang, Yong-Wei; Liu, Hong-Lin; Li, Cheng-Hui; Sui, Wei-Guo; Deng, Hong-Kui; Lou, Jin-Ning

    2013-01-01

    With the shortage of donor organs for islet transplantation, insulin-producing cells have been generated from different types of stem cell. Human fetal pancreatic stem cells have a better self-renewal capacity than adult stem cells and can readily differentiate into pancreatic endocrine cells, making them a potential source for islets in diabetes treatment. In the present study, the functions of pancreatic islets derived from human fetal pancreatic progenitor cells were evaluated in vitro and in vivo. Human pancreatic progenitor cells isolated from the fetal pancreas were expanded and differentiated into islet endocrine cells in culture. Markers for endocrine and exocrine functions as well as those for alpha and beta cells were analyzed by immunofluorescent staining and enzyme-linked immunosorbent assay (ELISA). To evaluate the functions of these islets in vivo, the islet-like structures were transplanted into renal capsules of diabetic nude mice. Immunohistochemical staining for human C-peptide and human mitochondrion antigen was applied to confirm the human origin and the survival of grafted islets. Human fetal pancreatic progenitor cells were able to expand in medium containing basic fibroblast growth factor (bFGF) and leukemia inhibitor factor (LIF), and to differentiate into pancreatic endocrine cells with high efficiency upon the actions of glucagon-like peptide-1 and activin-A. The differentiated cells expressed insulin, glucagon, glucose transporter-1 (GLUT1), GLUT2 and voltage-dependent calcium channel (VDCC), and were able to aggregate into islet-like structures containing alpha and beta cells upon suspension. These structures expressed and released a higher level of insulin than adhesion cultured cells, and helped to maintain normoglycemia in diabetic nude mice after transplantation. Human fetal pancreatic progenitor cells have good capacity for generating insulin producing cells and provide a promising potential source for diabetes treatment.

  5. Synthesis, solubility, plasma stability, and pharmacological evaluation of novel sulfonylhydrazones designed as anti-diabetic agents

    Directory of Open Access Journals (Sweden)

    Zapata-Sudo G

    2016-09-01

    Full Text Available Gisele Zapata-Sudo,1,2 Isabelle Karine da Costa Nunes,2 Josenildo Segundo Chaves Araujo,1,2 Jaqueline Soares da Silva,2 Margarete Manhães Trachez,2,3 Tiago Fernandes da Silva,1 Filipe P da Costa,2 Roberto Takashi Sudo,1,2 Eliezer J Barreiro,1,2 Lídia Moreira Lima1,2 1National Institute of Science and Technology on Drugs and Medicines, Federal University of Rio de Janeiro, Laboratory of Evaluation and Synthesis of Bioactive Compounds, Center of Health Sciences, Rio de Janeiro, Brazil; 2Program of Research in Drug Development, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 3Department of Anesthesiology, Fluminense Federal University, Rio de Janeiro, Brazil Abstract: Neuropathy is a serious complication of diabetes that has a significant socioeconomic impact, since it frequently demands high levels of health care consumption and compromises labor productivity. Recently, LASSBio-1471 (3 was demonstrated to improve oral glucose tolerance, reduce blood glucose levels, and display an anti-neuropathy effect in a murine streptozotocin-induced diabetes model. In the present work, we describe the design, synthesis, solubility, plasma stability, and pharmacological evaluation of novel sulfonylhydrazone derivatives (referred to herein as compounds 4–9, which were designed by molecular modification based on the structure of the prototype LASSBio-1471 (3. Among the compounds tested, better plasma stability was observed with 4, 5, and 9 in comparison to compounds 6, 7, and 8. LASSBio-1773 (7, promoted not only hypoglycemic activity but also the reduction of thermal hyperalgesia and mechanical allodynia in a murine model of streptozotocin-induced diabetic neuropathic pain. Keywords: diabetes, sulfonylhydrazone, hypoglycemic activity, druglikeness, plasma stability, metabolite

  6. Temperature and precipitation in the context of the annual cycle over Asia: Model evaluation and future change

    Science.gov (United States)

    Moon, Suyeon; Ha, Kyung-Ja

    2017-05-01

    Since the early or late arrival of monsoon rainfall can be devastating to agriculture and economy, the prediction of the onset of monsoon is a very important issue. The Asian monsoon is characterized by a strong annual cycle with rainy summer and dry winter. Nevertheless, most of monsoon studies have focused on the seasonal-mean of temperature and precipitation. The present study aims to evaluate a total of 27 coupled models that participated in phase 5 of the Coupled Model Intercomparison Project (CMIP5) for projection of the time evolution and the intensity of Asian monsoon on the basis of the annual cycle of temperature and precipitation. And future changes of onset, retreat, and intensity of monsoon are analyzed. Four models for good seasonal-mean (GSM) and good harmonic (GH) groups, respectively, are selected. GSM is based on the seasonal-mean of temperature and precipitation in summer and winter, and GH is based on the annual cycle of temperature and precipitation which represents a characteristic of the monsoon. To compare how well the time evolution of the monsoon is simulated in each group, the onset, retreat, and duration of Asian monsoon are examined. The highest pattern correlation coefficient (PCC) of onset, retreat, and duration between the reanalysis data and model outputs demonstrates that GH models' MME predicts time evolution of monsoon most precisely, with PCC values of 0.80, 0.52, and 0.63, respectively. To predict future changes of the monsoon, the representative concentration pathway 4.5 (RCP 4.5) experiments for the period of 2073-2099 are compared with historical simulations for the period of 1979-2005 from CMIP5 using GH models' MME. The Asian monsoon domain is expanded by 22.6% in the future projection. The onset date in the future is advanced over most parts of Asian monsoon region. The duration of summer Asian monsoon in the future projection will be lengthened by up to 2 pentads over the Asian monsoon region, as a result of advanced

  7. Evaluation of OneTouch Verio(®), a new blood glucose self-monitoring system for patients with diabetes

    DEFF Research Database (Denmark)

    Littmann, Karin; Petersen, Eva; Pussinen, Christel

    2013-01-01

    . The objective of the present study was to evaluate the analytical performance of the OneTouch Verio(®). Method. The OneTouch Verio(®) was evaluated by the Scandinavian evaluation of laboratory equipment for primary healthcare (SKUP) according to a protocol based on ISO 15197 and the American Diabetes...

  8. Evaluation of OneTouch Verio, a new blood glucose self-monitoring system for patients with diabetes

    DEFF Research Database (Denmark)

    Littman, Karin; Petersen, Eva R.B.; Pussinen, Christel

    2013-01-01

    . The objective of the present study was to evaluate the analytical performance of the OneTouch Verio®. Method. The OneTouch Verio® was evaluated by the Scandinavian evaluation of laboratory equipment for primary healthcare (SKUP) according to a protocol based on ISO 15197 and the American Diabetes Association...

  9. Food allergy in Asia.

    Science.gov (United States)

    Shek, Lynette Pei-Chi; Lee, Bee Wah

    2006-06-01

    Food allergy is increasing in prevalence in Western populations, but little is known about it in Asia. The perception is that the prevalence in this region is low, but is likely to increase with the global increase in allergy. Asia is unique because of the many different cultures and eating habits, with the resulting occurrence of unique food allergens. This review describes the epidemiology and clinical features of food allergy, and introduces some of the unusual food allergens in Asia. Recent studies describing the pattern of anaphylaxis and the role of food triggers show that food is an important cause of severe allergic reactions in Asia. Progress has been made on the characterization of unique food allergens from the region. Peanut and tree nuts are rarely the cause of allergic reactions in Asia. The lack of availability of epinephrine auto-injectors in many countries is an important issue that needs to be addressed. The pattern of food allergy in Asia is unique. Unfortunately, data from many parts of Asia are still lacking. Large, well-designed epidemiological studies are needed so that the scale of the problem can be understood, public awareness can be increased and important food allergens in the region can be identified.

  10. Neurology in Asia.

    Science.gov (United States)

    Tan, Chong-Tin

    2015-02-10

    Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.

  11. Evaluating the impact of an enhanced primary care diabetes service on diabetes outcomes: A before-after study.

    Science.gov (United States)

    Seidu, S; Bodicoat, D H; Davies, M J; Daly, H; Stribling, B; Farooqi, A; Brady, E M; Khunti, K

    2017-04-01

    Diabetes is an ambulatory care-sensitive condition and a high quality primary care or risk factor control can lead to a decrease in the risk of non-elective hospitalisations while ensuring continuity of care with usual primary care teams. In this before and after study, eight primary care practices providing a newer enhanced diabetes model of care in Leicester UK, were compared with matched neighbouring practices with comparable demographic features providing a more expensive integrated specialist-community care diabetes service. The primary outcome at twelve months was to demonstrate equivalence in non-elective bed days. The enhanced practices had primary care physicians and nurses with an interest in diabetes who attended monthly diabetes education meetings and provided care plans and audits. The control practices provided an integrated primary-specialist care service. The difference between the mean change in the non-elective bed days from baseline and at follow up in core and enhanced practices was not statistically significant (mean=2.20 per 100 patients, 95% CI=-0.92 to 5.31 per 100 patients, p=0.14). The analogous change for first outpatients' attendance were 0.23 per 100 patients (95% CI=-0.47 to 0.52 per 100 patients p=0.92) and for diabetes related complications admissions was 0.30 per 100 patients (95% CI=-0.85 to 1.45 per 100 patients p=0.55). A model of enhanced primary care based diabetes care appears unlikely to increase hospitalisations, outpatients' attendance or admissions for diabetes related complications. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  12. Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients.

    Science.gov (United States)

    Hu, Yu-Ming; Zhao, Li-Hua; Zhang, Xiu-Lin; Cai, Hong-Li; Huang, Hai-Yan; Xu, Feng; Chen, Tong; Wang, Xue-Qin; Guo, Ai-Song; Li, Jian-An; Su, Jian-Bin

    2018-02-06

    Diabetic peripheral neuropathy (DPN), a common microvascular complication of diabetes, is linked to glycaemic derangements. Glycaemic variability, as a pattern of glycaemic derangements, is a key risk factor for diabetic complications. We investigated the association of glycaemic variability with DPN in a large-scale sample of type 2 diabetic patients. In this cross-sectional study, we enrolled 982 type 2 diabetic patients who were screened for DPN and monitored by a continuous glucose monitoring (CGM) system between February 2011 and January 2017. Multiple glycaemic variability parameters, including the mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), standard deviation of glucose (SD), and 24-h mean glucose (24-h MG), were calculated from glucose profiles obtained from CGM. Other possible risks for DPN were also examined. Of the recruited type 2 diabetic patients, 20.1% (n = 197) presented with DPN, and these patients also had a higher MAGE, MODD, SD, and 24-h MG than patients without DPN (p diabetic duration, HOMA-IR, and hemoglobin A1c (HbA1c) were found to be independent contributors to DPN, and the corresponding odds ratios (95% confidence interval) were 4.57 (3.48-6.01), 1.10 (1.03-1.17), 1.24 (1.09-1.41), and 1.33 (1.15-1.53), respectively. Receiver operating characteristic analysis indicated that the optimal MAGE cutoff value for predicting DPN was 4.60 mmol/L; the corresponding sensitivity was 64.47%, and the specificity was 75.54%. In addition to conventional risks including diabetic duration, HOMA-IR and HbA1c, increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.

  13. Evaluation of Salivary Glucose, IgA and Flow Rate in Diabetic Patients: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    P. Bakianian Vaziri

    2010-03-01

    Full Text Available Objective: An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls.Materials and Methods: Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelometricand Pars method were used to measure salivary IgA and salivary glucose concentrations,respectively. Statistical analysis was performed by Chi-square and t test.Results: There were no significant differences in salivary IgA and glucose concentrations between type 1 and type 2 diabetic patients and their matched control subjects (P>0.05.Salivary flow rate was significantly lower in diabetic patients (P<0.05. In addition,DMFT was higher in diabetic patients than the controls.Conclusion: Determination of salivary constituents may be useful in the description and management of oral findings in diabetic patients.

  14. Zika virus in Asia

    Directory of Open Access Journals (Sweden)

    Veasna Duong

    2017-01-01

    Full Text Available Zika virus (ZIKV is an emerging mosquito-borne virus that was first isolated from a sentinel rhesus monkey in the Zika Forest in Uganda in 1947. In Asia, the virus was isolated in Malaysia from Aedes aegypti mosquitoes in 1966, and the first human infections were reported in 1977 in Central Java, Indonesia. In this review, all reported cases of ZIKV infection in Asia as of September 1, 2016 are summarized and some of the hypotheses that could currently explain the apparently low incidence of Zika cases in Asia are explored.

  15. Zika virus in Asia.

    Science.gov (United States)

    Duong, Veasna; Dussart, Philippe; Buchy, Philippe

    2017-01-01

    Zika virus (ZIKV) is an emerging mosquito-borne virus that was first isolated from a sentinel rhesus monkey in the Zika Forest in Uganda in 1947. In Asia, the virus was isolated in Malaysia from Aedes aegypti mosquitoes in 1966, and the first human infections were reported in 1977 in Central Java, Indonesia. In this review, all reported cases of ZIKV infection in Asia as of September 1, 2016 are summarized and some of the hypotheses that could currently explain the apparently low incidence of Zika cases in Asia are explored. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  16. Evaluation of sleep profile in schizophrenia patients treated with extended-release paliperidone: an open-label prospective study in Southeast Asia

    Directory of Open Access Journals (Sweden)

    Kongsakon R

    2017-10-01

    Full Text Available Ronnachai Kongsakon,1 Nuntika Thavichachart,2 Ka Fai Chung,3 Leslie Lim,4 Beverly Azucena,5 Elizabeth Rondain,6 Benson Go,7 Fe Costales,8 Osot Nerapusee9 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Division of Psychiatry, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand; 3Department of Psychiatry, University of Hong Kong, Hong Kong, People’s Republic of China; 4Department of Psychiatry, Singapore General Hospital, Singapore; 5National Center for Mental Health, Mandaluyong, Philippines; 6Makati Medical Center, Makati, Philippines; 7Northern Mindanao Medical Center, Cagayan De Oro, Misamis Oriental, Philippines; 8Perpetual Succour Hospital, Cebu, Philippines; 9Medical Affairs, Janssen‑Cilag, Bangkok, Thailand Objective: To evaluate the effect of 6 months of treatment with paliperidone extended-release (ER tablets on the sleep profile of patients with schizophrenia.Methods: A total of 984 patients meeting the The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria for schizophrenia who switched their antipsychotic to paliperidone ER were recruited from 61 sites in five countries in Southeast Asia. We recorded patient demographics and assessed sleep quality and daytime drowsiness using visual analog scales.Results: Approximately 70% of patients completed the 6-month study. After the use of paliperidone ER, patients reported significantly better sleep quality (76.44 vs 65.48; p<0.001 and less daytime drowsiness compared with their baseline value (23.18 vs 34.22; p<0.001. Factors predicting sleep profile improvement were completion of the study and higher baseline Positive and Negative Syndrome Scale scores.Conclusion: Paliperidone ER can help schizophrenia patients to improve sleep quality and reduce daytime drowsiness; this was seen especially in the patients who completed the 6-month

  17. A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa--the International epidemiologic Databases to Evaluate AIDS (IeDEA).

    Science.gov (United States)

    2013-01-15

    There are limited data on paediatric HIV care and treatment programmes in low-resource settings. A standardized survey was completed by International epidemiologic Databases to Evaluate AIDS paediatric cohort sites in the regions of Asia-Pacific (AP), Central Africa (CA), East Africa (EA), Southern Africa (SA) and West Africa (WA) to understand operational resource availability and paediatric management practices. Data were collected through January 2010 using a secure, web-based software program (REDCap). A total of 64,552 children were under care at 63 clinics (AP, N=10; CA, N=4; EA, N=29; SA, N=10; WA, N=10). Most were in urban settings (N=41, 65%) and received funding from governments (N=51, 81%), PEPFAR (N=34, 54%), and/or the Global Fund (N=15, 24%). The majority were combined adult-paediatric clinics (N=36, 57%). Prevention of mother-to-child transmission was integrated at 35 (56%) sites; 89% (N=56) had access to DNA PCR for infant diagnosis. African (N=40/53) but not Asian sites recommended exclusive breastfeeding up until 4-6 months. Regular laboratory monitoring included CD4 (N=60, 95%), and viral load (N=24, 38%). Although 42 (67%) sites had the ability to conduct acid-fast bacilli (AFB) smears, 23 (37%) sites could conduct AFB cultures and 18 (29%) sites could conduct tuberculosis drug susceptibility testing. Loss to follow-up was defined as >3 months of lost contact for 25 (40%) sites, >6 months for 27 sites (43%) and >12 months for 6 sites (10%). Telephone calls (N=52, 83%) and outreach worker home visits to trace children lost to follow-up (N=45, 71%) were common. In general, there was a high level of patient and laboratory monitoring within this multiregional paediatric cohort consortium that will facilitate detailed observational research studies. Practices will continue to be monitored as the WHO/UNAIDS Treatment 2.0 framework is implemented.

  18. Evaluation of the Informational Content, Readability and Comprehensibility of Online Health Information on Monogenic Diabetes.

    Science.gov (United States)

    Guan, Yue; Maloney, Kristin A; Roter, Debra L; Pollin, Toni I

    2017-09-26

    The purpose of this study was to assess the informational content, readability, suitability and comprehensibility of websites offering educational information about monogenic diabetes available to patients. The top 20 results from 15 queries in four search engines were screened. Content analysis was performed by two independent coders. Readability was determined using Flesch-Kincaid grade level (FKGL) and Simplified Measure of Goobledygook (SMOG). The Comprehensibility Assessment of Materials (SAM + CAM) scale was utilized to evaluate website suitability and comprehensibility. Only 2% (N = 29) of 1200 screened websites met inclusion criteria. Content analysis showed that 16 websites presented information on at least the most common forms of MODY (1, 2 and 3), four addressed the utility of genetic counseling, and none included support resources for patients. All websites exceeded the consensus readability level (6th grade) as assessed by FKGL (10.1 grade) and SMOG (12.8 ± 1.5 grades). Although the majority (N = 20) of websites had an overall "adequate" to "superior" quality score (SAM + CAM score > = 40%), more than one-third scored "not suitable" in categories of content, literacy demand, graphics, and learning motivation. The online educational resources for monogenic diabetes have a high readability level and require improvement in ease of use and comprehensibility for patients with diabetes.

  19. Papaya (Carica papaya) consumption is unsafe in pregnancy: fact or fable? Scientific evaluation of a common belief in some parts of Asia using a rat model.

    Science.gov (United States)

    Adebiyi, Adebowale; Adaikan, P Ganesan; Prasad, R N V

    2002-08-01

    Using controlled in vivo and in vitro pharmacological methods, we evaluated the safety of papaya (Carica papaya) consumption in pregnancy with reference to its common avoidance during pregnancy in some parts of Asia. Ripe papaya (Carica papaya L. (Caricaecae) blend (500 ml/l water) was freely given to four groups of Sprague-Dawley rats at different stages of gestation (days 1-5, 6-11, 12-17 and 1-20). The control group received water. The effect of ripe papaya juice and crude papaya latex on pregnant and non-pregnant rats' uteri was also evaluated using standard isolated-organ-bath methods. The daily volumes (ml) of ripe papaya blend consumed by the treated group were significantly (Ppapaya relative to the control. No sign of fetal or maternal toxicity was observed in all the groups. In the in vitro study, ripe papaya juice (0.1-0.8 ml) did not show any significant contractile effect on uterine smooth muscles isolated from pregnant and non-pregnant rats; conversely, crude papaya latex (0.1-3.2 mg/ml) induced spasmodic contraction of the uterine muscles similar to oxytocin (1-64 mU/ml) and prostaglandin F(2 alpha) (0.028-1.81 microm). The response of the isolated rat uterine smooth muscles to 0.2 mg crude papaya latex/ml was comparable to 0.23 microm prostaglandin F(2 alpha) and 32 mU oxytocin/ml. In the 18-19 d pregnant rat uterus, the contractile effect of crude papaya latex was characterized by tetanic spasms. The results of the present study suggest that normal consumption of ripe papaya during pregnancy may not pose any significant danger. However, the unripe or semi-ripe papaya (which contains high concentration of the latex that produces marked uterine contractions) could be unsafe in pregnancy. Though evaluation of potentially toxic agents often relies on animal experimental results to predict risk in man, further studies will be necessary to ascertain the ultimate risk of unripe papaya-semi-ripe papaya consumption during pregnancy in man.

  20. Role of Clinical Neuropsychologists in the Evaluation and Management of Diabetes Mellitus in Ghana: A Position Statement

    Directory of Open Access Journals (Sweden)

    Jacob Owusu Sarfo

    2014-10-01

    Full Text Available Ghana’s Ministry of Health is gradually improving the state of mental health among patients with biomedical conditions. Nonetheless, many recent studies have showed that some chronic medical conditions present cognitive deficits that need specialist evaluation and care. The aim of this paper is to provide a summary analysis regarding the current need for neuropsychologists in Ghana’s diabetes care. The rationale is to move for a paradigm shift with regards to the current state of diabetes care in Ghana. Thus, it advocates for policy reform in the management of DM and the inclusion of neuropsychologists among Ghana’s existing structure for diabetes care.

  1. Evaluating the effect of knowledge, attitude and practice on self-management in patients with type 2 diabetes.

    Science.gov (United States)

    Karbalaeifar, Ronak; Kazempour-Ardebili, Sara; Amiri, Parisa; Ghannadi, Shima; Tahmasebinejad, Zhale; Amouzegar, Atieh

    2016-12-01

    Type 2 diabetes mellitus is a common disease imposing a great economic burden to health systems. As the prevalence of type 2 diabetes in Iran has grown over the past decades, it has become necessary to evaluate the level of knowledge, attitude and practice of type 2 diabetic patients in our country for policy planning to increase the patients' awareness of diabetes and its complications and, in the long run, decrease costs of treatment. The aim of this study was to evaluate the level of knowledge, attitude and practice of patients with diabetes and its relationship with self-managing of disease and quality of life. This study was conducted with the aim of assessing the knowledge, attitude, self-reported practice, self-care and health-related quality of life (HRQoL) among patients attending diabetes clinic of Torfeh academic hospital in Tehran, Iran, during April to June 2014. The study population comprised of 120 type 2 diabetic patients aged above 30 years receiving anti-diabetic medications visiting Torfeh's outpatient diabetes clinic for follow-up care. Face-to-face interviews were carried out to fill five questionnaires evaluating patients' knowledge, attitude, practice, self-care and HRQoL. Demographic characteristics were recorded at the beginning of the study. Laboratory data were extracted from patients' most recent medical documents. Data were analyzed using Statistical Package for Social Science (SPSS) version 21. 120 type 2 diabetic patients (86 female and 34 male patients) with mean age of 55.98 ± 9.50 years were evaluated. The mean score of knowledge, attitude, practice, self-care and HRQoL was 67.99 ± 10.38, 73.43 ± 11.84, 64.69 ± 16.63, 58.22 ± 12.24 and -1.13 ± 0.6, respectively. There was a significant negative relationship between HbA1c and patients' practice. We did not find any correlation between patients' knowledge, attitude or practice and their HRQoL. There was a significant direct relationship between patients' knowledge

  2. Histomorphometric evaluation of bone regeneration using autogenous bone and beta-tricalcium phosphate in diabetic rabbits

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    Živadinović Milka

    2016-01-01

    Full Text Available Background/Aim. The mechanism of impaired bone healing in diabetes mellitus includes different tissue and cellular level activities due to micro- and macrovascular changes. As a chronic metabolic disease with vascular complications, diabetes affects a process of bone regeneration as well. The therapeutic approach in bone regeneration is based on the use of osteoinductive autogenous grafts as well as osteoconductive synthetic material, like a β-tricalcium phosphate. The aim of the study was to determine the quality and quantity of new bone formation after the use of autogenous bone and β-tricalcium phosphate in the model of calvarial critical-sized defect in rabbits with induced diabetes mellitus type I. Methods. The study included eight 4-month-old Chincilla rabbits with alloxan-induced diabetes mellitus type I. In all animals, there were surgically created two calvarial bilateral defects (diameter 12 mm, which were grafted with autogenous bone and β-tricalcium phosphate (n = 4 or served as unfilled controls (n = 4. After 4 weeks of healing, animals were sacrificed and calvarial bone blocks were taken for histologic and histomorphometric analysis. Beside descriptive histologic evaluation, the percentage of new bone formation, connective tissue and residual graft were calculated. All parameters were statistically evaluated by Friedman Test and post hock Wilcoxon Singed Ranks Test with a significance of p < 0.05. Results. Histology revealed active new bone formation peripherally with centrally located connective tissue, newly formed woven bone and well incorporated residual grafts in all treated defects. Control samples showed no bone bridging of defects. There was a significantly more new bone in autogeonous graft (53% compared with β-tricalcium phosphate (30%, (p < 0.030 and control (7%, (p < 0.000 groups. A significant difference was also recorded between β-tricalcium phosphate and control groups (p < 0.008. Conclusion. In the present

  3. Evaluation of a type 1 diabetes serum cohort by SELDI-TOF MS protein profiling

    DEFF Research Database (Denmark)

    Albrethsen, J.; Kaas, A.; Schonle, E.

    2009-01-01

    Proteomics analysis of serum from patients with type 1 diabetes (T1D) may lead to novel biomarkers for prediction of disease and for patient monitoring. However, the serum proteome is highly sensitive to sample processing and before proteomics biomarker research serum cohorts should preferably...... be examined for potential bias between sample groups. S ELDI-TOF MS protein profiling was used for preliminary evaluation of a biological-bank with 766 serum samples from 270 patients with T1D, collected at 18 different paediatric centers representing 15 countries in Europe and Japan over 2 years (2000...

  4. Podiatry evaluation of a chitosan gelling fibre dressing in diabetic foot ulceration.

    Science.gov (United States)

    Walker, Angela

    2016-06-23

    The purpose of this small evaluation on five patients presenting to community podiatry services in Birmingham with foot ulceration was to explore common problems associated with diabetes and other high-risk conditions and illustrate the clinical effectiveness and experience of using a chitosan absorbent gelling fibre dressing (KytoCel®, Aspen Medical). Each of these case studies bought their individual complex issues and complications that affected the healing process. General wound care involved debridement, if required, dressings, pressure redistribution addressing footwear needs, systemic antibiotics where required, and shared care with the multidisciplinary team (MDT) in secondary care where appropriate.

  5. Efect of periodontal disease and non surgical periodontal treatment on C-reactive protein. Evaluation of type 1 diabetic patients

    OpenAIRE

    Llambés Arenas, Fernando; Silvestre Donat, Francisco Javier; Hernández Mijares, Antonio; Guiha, Rami; Bautista, Daniel; Caffesse, Raul G.

    2012-01-01

    Objectives: The purpose of this study was to analyze how anti-infectious periodontal treatment affects C reactive protein (CRP) values in patients with type 1 diabetes, and correlate baseline CRP levels with periodontal disease severity. Study Design: A cohort of fifty three subjects with type 1 diabetes and moderate to severe periodontitis were recruited. Periodontal parameters were measured, and blood samples were obtained to evaluate high-sensitivity C-reactive protein (hs-CRP). Group 1 wa...

  6. Haemoglobinopathies in Southeast Asia

    OpenAIRE

    Fucharoen, Suthat; Winichagoon, Pranee

    2011-01-01

    In Southeast Asia ?-thalassaemia, ?-thalassaemia, haemoglobin (Hb) E and Hb Constant Spring (CS) are prevalent. The abnormal genes in different combinations lead to over 60 different thalassaemia syndromes, making Southeast Asia the locality with the most complex thalassaemia genotypes. The four major thalassaemic diseases are Hb Bart's hydrops fetalis (homozygous ?-thalassaemia 1), homozygous ?-thalassaemia, ?-thalassaemia/Hb E and Hb H diseases. ?-Thalassaemia, most often, occurs from gene ...

  7. Southeast Asia Report.

    Science.gov (United States)

    1987-04-23

    195010 JPRS-SEA-87-059 23 APRIL 1987 Dis iv ib ulion . ü r,limited TV A XZB; Southeast Asia Report FBIS FOREIGN BROADCAST INFORMATION SERVICE...87-059 23 APRIL 1987 SOUTHEAST ASIA REPORT CONTENTS INDONESIA Jakarta’s Position on Afghan Issue Praised (ANTARA NEWS BULLETIN, 17 Mar 87) 1...various dates) 91 Daily Worries About Overpopulation , Unemployment (Editorial; BAN MUANG, 26 Jan 87) 1°5 Briefs Smugglers to PRK ^J° Workers

  8. Improving capacity for evidence-based practice in South East Asia: evaluating the role of research fellowships in the SEA-ORCHID Project

    Directory of Open Access Journals (Sweden)

    Martis Ruth

    2010-05-01

    Full Text Available Abstract Background Fellowships are a component of many professional education programs. They provide opportunities to develop skills and competencies in an environment where time is protected and resources and technical support are more readily available. The SEA-ORCHID fellowships program aimed to increase capacity for evidence-based practice and research synthesis, and to encourage fellows to become leaders in these areas. Methods Fellows included doctors, nurses, midwives and librarians working in the maternal and neonatal areas of nine hospitals in South East Asia. Fellowships were undertaken in Australia and involved specific outputs related to evidence-based practice or research synthesis. Training and support was tailored according to the type of output and the fellow's experience and expertise. We evaluated the fellowships program quantitatively and qualitatively through written evaluations, interviews and follow-up of fellowship activities. Results During 2006-07, 23 fellows from Thailand, Indonesia, Malaysia and the Philippines undertook short-term fellowships (median four weeks in Australia. The main outputs were drafts of Cochrane systematic reviews, clinical practice guidelines and protocols for randomised trials, and training materials to support evidence-based practice. Protocols for Cochrane systematic reviews were more likely to be completed than other outcomes. The fellows identified several components that were critical to the program's overall success; these included protected time, tailored training, and access to technical expertise and resources. On returning home, fellows identified a lack of time and limited access to the internet and evidence-based resources as barriers to completing their outputs. The support of colleagues and senior staff was noted as an important enabler of progress, and research collaborators from other institutions and countries were also important sources of support. Conclusions The SEA

  9. Evaluation of the Wound Healing Properties of Luteolin Ointments on Excision and Incision Wound Models in Diabetic and Non-Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Yusuf Ozay

    2018-07-01

    Full Text Available Luteolin , which is structurally classified under the flavonoids, is naturally distributed abundant among medicinal plants, vegetables and fruits. The wound healing effects of Luteolin ointments were evaluated for incision and excision wound models on non-diabetic and Streptozotocin induced diabetic rats by using macroscopical, biomechanical, biochemical and histopathological methods. Two different concentrations (0.5 % and 1 % (w/w of the Luteolin ointment were prepared with the mixture of glycol stearate:propylene glycol:liquid paraffin (3:6:1 and 0.5 g of the ointments were applied topically on wounds once daily for 7 and 14 days. During the experiments, wounds were visually observed, photographically documented and wound areas were measured. After 7 and 14 days treatment, animals were sacrificed under anesthesia and hydroxyproline measurement and biomechanical analysis were performed. Histopathology of the wound area was evaluated considering features of re-epithelialization, thickness of the granulation tissue, angiogenesis, presence of inflammation, number of mast cells. Outcomes of this study revealed that Luteolin ointments improved wound healing process of skin tissue both in non-diabetic and diabetic wounds. The best wound healing activity was observed in incision and excision wounds (97.6 %, 96.1 %, respectively treated with 0.5 % (w/w Luteolin ointment on day 14 according to macroscopic results.

  10. Evaluation of thickness of cementum of periodontally diseased teeth of non-diabetic and type 2 diabetic patients: A scanning electron microscopy study

    Directory of Open Access Journals (Sweden)

    Radhika Gupta

    2013-01-01

    Full Text Available Background: It is suggested that diabetes plays an important role in tooth loss. The periodontal structure and alveolar bone architecture in diabetics have revealed alterations. However, changes in cementum of diabetics with periodontal disease have not been evaluated adequately. Thus, the aim of the study is to evaluate and compare the thickness of cementum in diseased and healthy areas of roots of teeth with chronic periodontitis from non-diabetic (group I and type 2 diabetic patients (group II. Materials and Methods: Thirty incisors indicated for extraction as a result of chronic periodontitis from group I and group II were selected. Measurements of Probing Depth (PD and Clinical Attachment Loss (CAL were taken prior to extractions. Area of the root surface above the CAL (notch was designated as diseased, while the area below the CAL (notch was designated as healthy. The extracted tooth samples were sectioned longitudinally and were evaluated by scanning electron microscopy (SEM. Descriptive statistical analysis was performed. Results of continuous measurements were presented as Mean ΁ SD. Results: The results showed that in both groups the thickness of cementum in diseased areas was lower in comparison to the thickness in healthy areas. The mean thickness of cementum in both healthy and diseased areas was higher in group II compared to group I, though the differences in both were not statistically significant. Conclusion: Within the limits of the present study, group II showed greater mean thickness of cementum in both healthy and diseased areas compared to group I, though the differences were not statistically significant.

  11. Evaluating the use of a scanning laser-derived oedema index to grade diabetic retinopathy and maculopathy.

    Science.gov (United States)

    Styles, Caroline J; Park, Serena J K; McGhee, Charles N J; Gamble, Greg; Donaldson, Mark L

    2007-01-01

    To evaluate the Heidelburg Retina Tomograph II (HRTII) retinal module as a tool for grading severity of retinopathy in a diabetic retinal screening and treatment service. Seventy-seven consecutive patients with type 2 diabetes underwent scanning laser tomography using the HRTII. Scan data were analysed using the proprietary macular module software and oedema indices calculated for each of nine topographic macular zones. Two consultant ophthalmologists, masked to the result of the HRTII scans, graded each subject for severity of retinopathy and presence of macular oedema. The oedema indices were analysed statistically to determine whether these correlated with severity of retinopathy and presence of macular oedema. There is an increased oedema index in severe non-proliferative diabetic retinopathy in the outer temporal zone compared with lesser grades of diabetic retinopathy (P = 0.001). In patients with clinically detectable macular oedema, the oedema index from the 500-microm-diameter central zone was significantly higher than those without (P = 0.03). The scanning laser-derived oedema index differentiated between moderate and severe non-proliferative diabetic retinopathy in this series and detected diabetic macular oedema. Further development of this technology may provide an important tool to supplement retinal photographic surveillance in eye clinics overwhelmed by an increasing prevalence of type 2 diabetes.

  12. Prevalence of food allergies in South Asia.

    Science.gov (United States)

    Arakali, Schweta R; Green, Todd D; Dinakar, Chitra

    2017-01-01

    To evaluate the published medical literature on the prevalence and types of food allergies in South Asia. A PubMed search was performed using the keywords India and food allergy, Asia and food allergy, and South Asia and food allergy for any period. Articles cited in selected studies were reviewed for their appropriateness of inclusion into this review. Publications were included that were original research and fit the topic of food allergy and South Asia. South Asia is defined as region inclusive of India, Pakistan, Bangladesh, and Sri Lanka. A total of 169 articles were initially identified, and 47 were reviewed in detail for inclusion in this review. The primary focus was placed on 10 studies that consisted of case reports of newly reported or documented food allergy, survey studies that investigated food allergy prevalence in specific demographics, and prospective and cross-sectional studies with case controls, all of which investigated food allergy prevalence by allergy testing in a selected population. The medical literature on the prevalence and types of food allergy in South Asia indicates that there is a variety of unusual and unique allergens and an overall low incidence of food allergy. There is also an association of increased food allergy prevalence in individuals who live in metropolitan regions or who migrate to communities that have adopted westernization. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program.

    Science.gov (United States)

    Gutierrez, Jaime; Devia, Carlos; Weiss, Linda; Chantarat, Tongtan; Ruddock, Charmaine; Linnell, Jill; Golub, Maxine; Godfrey, Loyce; Rosen, Rosa; Calman, Neil

    2014-01-01

    The purpose of this study was to evaluate Fine, Fit, and Fabulous (FFF), a faith-based diabetes prevention program for black and Latino congregants at churches in low-income New York City neighborhoods. FFF includes nutrition education and fitness activities while incorporating Bible-based teachings that encourage healthy lifestyles. FFF is a 12-week, bilingual program developed by the Bronx Health REACH coalition, a Centers for Disease Control and Prevention-funded Center of Excellence for the Elimination of Disparities. This program has been implemented in 15 Bronx and Harlem churches, engaging a primarily black and Latino overweight and obese urban population. Pre-post surveys, nutrition tests, and weight logs were collected to assess knowledge, attitudes, and behaviors regarding healthy eating and physical activity. Participants (n = 183) reported statistically significant improvements in knowledge and healthy behaviors from baseline. Increased numbers of participants reported exercising in the past 30 days, eating fruit daily, being able to judge portion sizes, and reading food labels. Statistically significant numbers reported that they ate less fast food and were less likely to overeat at follow-up. The average weight loss across churches was 4.38 lbs or 2% of participants' initial body weight. Significant differences were observed when stratifying by race/ethnicity. Evaluation results show FFF's success at engaging overweight adults in behavior changes related to healthy eating and exercise. FFF demonstrates the potential of faith-based health interventions to address obesity and diabetes risk in high-need communities of color.

  14. Evaluation of anti-diabetic and alpha glucosidase inhibitory action of anthraquinones from Rheum emodi.

    Science.gov (United States)

    Arvindekar, Aditya; More, Tanaji; Payghan, Pavan V; Laddha, Kirti; Ghoshal, Nanda; Arvindekar, Akalpita

    2015-08-01

    Rheum emodi is used as a culinary plant across the world and finds an eminent role in the Ayurvedic and traditional Chinese systems of medicine. The plant is known to principally contain 1,8-dihydroxyanthraquinones (DHAQs) like rhein, aloe emodin, emodin, chrysophanol and physcion that possess diverse pharmacological and therapeutic actions. The present work deals with developing a platform technology for isolation of these DHAQs and evaluating their anti-diabetic potential. Herein, we report the anti-hyperglycemic activity and alpha glucosidase (AG) inhibitory actions of five isolated DHAQs from R. emodi. All the five isolated DHAQs showed good anti-hyperglycemic activity with aloe emodin exhibiting maximum lowering of blood glucose in an oral glucose tolerance test. However, on evaluation of the AG inhibitory potential of the DHAQs only emodin exhibited potent intestinal AG inhibition (93 ± 2.16%) with an IC50 notably lower than acarbose. Subsequent kinetic studies indicated a mixed type of inhibition for emodin. In vivo studies using oral maltose load showed almost total inhibition for emodin when compared to acarbose. Molecular docking studies revealed the presence of an allosteric topographically distinct 'quinone binding site' and showed that interaction with Ser 74 occurs exclusively with emodin, which is vital for AG inhibition. The net benefit from the glucose lowering effect and mixed type inhibition by emodin would enable the administration of a small dosage that is safe and non-toxic in the case of prolonged use in treating diabetes.

  15. Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs.

    Science.gov (United States)

    Fleeman, Linda M; Rand, Jacquie S

    2003-02-01

    To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus. Prospective clinical study. 10 dogs with diabetes mellitus. Paired 12-hour serial blood glucose concentration curves performed during 2 consecutive days were obtained on 3 occasions from each dog. Dogs received the same dose of insulin and meal every 12 hours on both days. For each pair of curves, comparison was made between the results of days 1 and 2. Mean absolute difference (without regard to sign) between days 1 and 2 for each parameter was significantly > 0, disproving the hypothesis that there is minimal day-to-day variability of serial blood glucose concentration curves when insulin dose and meals are kept constant. Coefficient of variation of the absolute difference between days 1 and 2 for each parameter ranged from 68 to 103%. Evaluation of the paired curves led to an opposite recommendation for adjustment of the insulin dose on day 2, compared with day 1, on 27% of occasions. Disparity between dosage recommendations was more pronounced when glucose concentration nadir was dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control.

  16. Evaluation of the effects of a diabetes educational program: a randomized clinical trial.

    Science.gov (United States)

    Torres, Heloísa de Carvalho; Pace, Ana Emília; Chaves, Fernanda Figueredo; Velasquez-Melendez, Gustavo; Reis, Ilka Afonso

    2018-02-05

    Evaluate the effectiveness of a diabetes mellitus educational program in primary health care. This cluster randomized trial was conducted in a sample of 470 people with type 2 diabetes mellitus from eight health units, randomly assigned to two groups: intervention (n = 231) and control (n = 239). The intervention group participated in the educational program composed of three strategies: group education, home visit, and telephone intervention. Simultaneously, the control group was monitored individually. Group monitoring took place over nine months in the year 2012. Clinical evaluations were performed at the initial time (T0), three (T3), six (T6) and nine (T9) months after the beginning of the intervention. After nine months of follow-up, 341 users remained in the study, 171 in the control group and 170 in the intervention group. The average age of users was 60.6 years. In both groups, statistically significant differences were observed in mean HbA1c levels over the follow-up time (p educational program model developed was effective to improve the glycemic control of the intervention group participants.

  17. Local media monitoring in process evaluation. Experiences from the Stockholm Diabetes Prevention Programme.

    Science.gov (United States)

    Andersson, Camilla Maria; Bjärås, Gunilla; Tillgren, Per; Ostenson, Claes-Göran

    2007-01-01

    We present a rationale and approach for longitudinal analyses of media coverage and content, and illustrate how media monitoring can be used in process evaluations. Within a community-based diabetes prevention project, the Stockholm Diabetes Prevention Program, we analyzed the frequency, prominence, and framing of physical activity in local newspapers of three intervention and two control municipalities. In total, 2,128 stories and advertisements related to physical activity were identified between the years 1997 and 2002. Although stories about physical activity were relatively few (n = 224), they were prominently located in all five local newspapers. Physical activity was framed rather similarly in the municipalities. Health aspects, however, were expressed to a greater extent in stories in two of the intervention municipalities. A limited portion (14%) of the articles could be linked directly to the program. It is not possible to assess to what extent the program has had a disseminating effect on the newspapers' health-related content in general, due to weaknesses of the process tracking system and limitations of the study design. Implications for the design is that an evaluative framework should be preplanned and include data collection about media relationships, media's interest in public health, media coverage prior to the program and coverage in other media for comparisons of general trends in the reporting. The material and the current database, however, provide a good basis for quantitative content analysis and qualitative discourse analysis to yield information on the type, frequency, and content of health reporting in local newspapers.

  18. mf-ERG effective evaluation of early and background diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Cun-Wen Pei

    2014-12-01

    Full Text Available AIM: To measure the retinal electrical activities in patients with diabetic retinopathy(DRby applying multifocal electroretinogram(mf-ERGand evaluate the degree of visual damage at different stages of DRMETHODS: Thirty cases(30 eyesaged 50~70 years old, excluding other diseases, were as normal group, and 99 cases(99 eyes diagnosed with type 2 diabetes were as experiment group. The cases received mf-ERG examination in the standard state, respectively. The results were statistically analyzedRESULTS: For DR patients with early and background stage, the reaction density of mf-ERG P1 wave decreased as the disease worsened, significantly reduced in non-proliferating stage and decreased more significantly in the background of the stage Ⅲ. This showed that in the macula, electrical activity had weakened before the retina without visual or morphological changes, and with the development of the disease, the electrical activity decreased more obviously. CONCLUSION: mf-ERG can evaluate the severity of DR, especially suit in the early and background period of DR.

  19. A survey of paediatric HIV programmatic and clinical management practices in Asia and sub-Saharan Africa—the International epidemiologic Databases to Evaluate AIDS (IeDEA

    Directory of Open Access Journals (Sweden)

    IeDEA Pediatric Working Group

    2013-01-01

    Full Text Available Introduction: There are limited data on paediatric HIV care and treatment programmes in low-resource settings. Methods: A standardized survey was completed by International epidemiologic Databases to Evaluate AIDS paediatric cohort sites in the regions of Asia-Pacific (AP, Central Africa (CA, East Africa (EA, Southern Africa (SA and West Africa (WA to understand operational resource availability and paediatric management practices. Data were collected through January 2010 using a secure, web-based software program (REDCap. Results: A total of 64,552 children were under care at 63 clinics (AP, N=10; CA, N=4; EA, N=29; SA, N=10; WA, N=10. Most were in urban settings (N=41, 65% and received funding from governments (N=51, 81%, PEPFAR (N=34, 54%, and/or the Global Fund (N=15, 24%. The majority were combined adult–paediatric clinics (N=36, 57%. Prevention of mother-to-child transmission was integrated at 35 (56% sites; 89% (N=56 had access to DNA PCR for infant diagnosis. African (N=40/53 but not Asian sites recommended exclusive breastfeeding up until 4–6 months. Regular laboratory monitoring included CD4 (N=60, 95%, and viral load (N=24, 38%. Although 42 (67% sites had the ability to conduct acid-fast bacilli (AFB smears, 23 (37% sites could conduct AFB cultures and 18 (29% sites could conduct tuberculosis drug susceptibility testing. Loss to follow-up was defined as >3 months of lost contact for 25 (40% sites, >6 months for 27 sites (43% and >12 months for 6 sites (10%. Telephone calls (N=52, 83% and outreach worker home visits to trace children lost to follow-up (N=45, 71% were common. Conclusions: In general, there was a high level of patient and laboratory monitoring within this multiregional paediatric cohort consortium that will facilitate detailed observational research studies. Practices will continue to be monitored as the WHO/UNAIDS Treatment 2.0 framework is implemented.

  20. Evaluation of plasma homocysteine status in streptozotocin induced-diabetes mellitus in rabbit

    Directory of Open Access Journals (Sweden)

    K Azimzadeh

    2009-08-01

    Full Text Available In this research, plasma homocysteine levels as an independent risk factor of cardiovascular disease was evaluated in streptozotocin induced diabetic New Zealand white rabbits. Twelve male New Zealand white rabbits were selected and allocated into two separate groups of test and control. Following confirmation of the rabbit’s health status (normal plasma glucose, urea and creatinine values, those in the test group received a single dose of streptozotocin at 65 mg/kg through the marginal ear vein while the control group were given normal saline solution. Blood samples were collected from the marginal ear vein after 24, 48 and 72 hours and then once every week for 12 weeks and plasma homocysteine, insulin and glucose levels were measured and statistically evaluated. The results indicated significant increase (p

  1. Primary care physicians' practice regarding diabetes mellitus diagnosis, evaluation and management in the West region of Cameroon.

    Science.gov (United States)

    Jingi, Ahmadou M; Nansseu, Jobert Richie N; Noubiap, Jean Jacques N

    2015-04-04

    Primary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists. The present study aimed to evaluate PCPs' approach towards diabetes mellitus (DM) diagnosis, evaluation and management in Cameroon. We carried-out a cross-sectional survey in February 2012 in the West Region of Cameroon. Using a structured pretested questionnaire, we interviewed all PCPs working in the region who were present at their working place when the investigators visited, and volunteered to be enrolled in the study. Sixty-six PCPs were interviewed. Their ages ranged from 24 to 56 years (mean 38.3, standard deviation 9.2 years). The levels of knowledge of PCPs regarding DM diagnosis were: 72.7%, 37.9%, 19.7% and 32.8% respectively obtained when using fasting plasma glucose, post-prandial glycemia, random glycemia and glycated hemoglobin as diagnostic tools. Only 6 PCPs (9.9%) prescribed the correct minimal work-up to evaluate diabetes patients at diagnosis. PCPs advised lifestyle modifications in 92.4% of cases, and thirty nine (53.1%) PCP's used to prescribe both generic and specialty oral anti-diabetic drugs in case of uncomplicated type 2 DM management. The two main classes of anti-diabetic drugs prescribed were biguanides (77.3%) and sulfonamides (60.6%). Nearly all PCPs (97%) used to give frequent follow-up appointments to their patients. Ninety eight point five percent of participants were willing to receive any further continuous training on DM management. PCPs knowledge and practices towards diabetes mellitus diagnosis, evaluation and management were not optimal, stressing the need to improve their capacities regarding diabetes care. As such, more educational initiatives should be taken on, alongside regular upgrade and dissemination of clinical guidelines.

  2. Simulation and evaluation of dust emissions with WRF-Chem (v3.7.1) and its relationship to the changing climate over East Asia from 1980 to 2015

    Science.gov (United States)

    Song, Hongquan; Wang, Kai; Zhang, Yang; Hong, Chaopeng; Zhou, Shenghui

    2017-10-01

    Dust particles have been long recognized to affect the atmospheric radiative balance and are influenced by climate change. Impacts of climate change on dust emissions in East Asia, however, are not well understood. In this work, we conduct an evaluation of meteorological variables and dust emissions using the Weather Research and Forecasting model coupled with chemistry (WRF-Chem) and examine the relationships between dust emissions and meteorological variables (wind speed, precipitation, and temperature) over East Asia during the period of 1980-2015. Model simulated surface meteorological variables compared well overall with surface-based observations, consistent with other WRF studies. Compared to observations, the coarse particulate matter (PM10-2.5) concentrations were underpredicted for most dust source regions of East Asia with a domain-wide mean bias and correlation of -40.2 μg m-3 and 0.5 against observations, respectively. Dust particulate concentrations simulated by WRF-Chem were found to reproduce the observed spatial variability in surface dust particulates over East Asia. The average annual dust emission (0 < r < 20 μm) is around 67.4 Tg yr-1 and the dust emission increased with the trend of 0.173 Tg yr-1 (R2 = 0.03, P = 0.32) in China and Mongolia over the past four decades. The spatial and temporal variations of dust emissions in China and Mongolia indicate that the annual dust flux has increased in desert areas of China and Mongolia, but decreased in most Gobi regions of China. Dust emission is significantly positively and negatively correlated with wind velocity and precipitation at the regional scale. Spatial patterns of seasonal correlations between dust flux and climate varies greatly during the period of 1980-2015.

  3. Evaluation of Salivary Secretory Immunoglobulin A Levels in Diabetic Patients and Association with Oral and Dental Manifestations

    Directory of Open Access Journals (Sweden)

    Shahla Kakoei

    2015-11-01

    Full Text Available Objectives: Oral and dental manifestations in diabetic patients can arise due to numerous factors, including elevated salivary secretory immunoglobulin A (s-IgA levels. This study aimed to evaluate s-IgA concentrations in patients with type 2 diabetes mellitus (T2DM and to investigate the association between s-IgA levels and oral and dental manifestations of T2DM. Methods: This cross-sectional descriptive study was carried out between October 2011 and September 2012 in Kerman, Iran, and included 260 subjects (128 patients with T2DM and 132 healthy controls. Unstimulated salivary samples were collected from all subjects and s-IgA levels were determined using the immunoturbidimetric method. The oral cavities and teeth of T2DM patients were evaluated for oral and dental manifestations. Results: Both diabetic and control subjects with higher concentrations of s-IgA had significantly higher numbers of decayed, missing or filled teeth (DMFT and periodontal index (PDI scores (P <0.050. s-IgA levels were significantly higher in subjects with oral candidiasis (P <0.050. Among diabetic patients, significantly higher s-IgA levels were concomitant with xerostomia and denture stomatitis (P ≤0.050. There were no significant differences between s-IgA concentrations and other oral or dental manifestations in either group. Conclusion: Individuals with a greater number of DMFT, a higher PDI score and oral candidiasis had significantly higher s-IgA levels. s-IgA levels were not significantly higher among diabetic patients in comparison to the control group. However, significantly higher s-IgA levels occurred with xerostomia and denture stomatitis in diabetic patients. In addition, s-IgA was significantly higher in patients with uncontrolled diabetes compared to those with controlled diabetes.

  4. Electricity in east Asia

    Energy Technology Data Exchange (ETDEWEB)

    Breeze, Paul

    1997-06-01

    Electricity in east Asia highlights all the current regulations and policies and brings you up to data with the latest developments in the power markets in east Asia. In particular, the report assesses utility privatisation and the role and opportunities for independent power producers. It includes: the background to east Asia and its political and economic environment; an overview of the power markets in the region; the natural resources available locally within the region; the power generation technologies being used in the region and the potential for advanced technologies and renewable energy sources; the financial situation, including what opportunities and restraints affect each country; the regulatory structures and political problems associated with private power generation; detailed case studies of the Three Gorges hydropower project in China and the development of nuclear power in east Asia. Electricity in east Asia contains detailed country profiles of China, Hong Kong, Japan, Macao, Mongolia, North Korea, South Korea and Taiwan. It is an indispensable tool for anyone wishing to do business in this highly diverse and exciting region. (Author)

  5. Evaluation of Parotid Salivary Glucose Level for Clinical Diagnosis and Monitoring Type 2 Diabetes Mellitus Patients.

    Science.gov (United States)

    Wang, Beibei; Du, Juan; Zhu, Zhao; Ma, Zhihong; Wang, Songlin; Shan, Zhaochen

    2017-01-01

    Background. To investigate the relationships among blood glucose, mixed saliva glucose, and parotid glucose in type 2 diabetes patients and to evaluate the diagnostic and monitoring value of salivary gland glucose in patients with type 2 diabetes (type 2DM). Material and Methods. Thirty patients with type 2DM and 30 healthy age- and sex-matched individuals were included in this study. Glucose levels in unstimulated mixed saliva and in unstimulated parotid saliva were measured by the glucose oxidase peroxidase method. Results. The blood glucose and parotid salivary glucose levels in type 2DM patients were significantly higher than those in the controls (P glucose, parotid salivary glucose, and mixed salivary glucose were 7.46 ± 1.44 mmol/L, 0.18 ± 0.19 mmol/L, and 3.17 × 10-2 ± 2.84 × 10-2 mmol/L, respectively, in the type 2DM group; the corresponding glucose levels in the control group were 5.56 ± 0.71 mmol/L, 7.70 × 10-2 ± 6.02 × 10-2 mmol/L, and 3.47 × 10-2 ± 2.79 × 10-2 mmol/L. The parotid salivary and blood glucose levels in type 2DM patients were strongly correlated; the linear regression equation for blood glucose and parotid salivary glucose was Y = 6.267X + 6.360, with r = 0.810. However, mixed salivary glucose levels were not significantly different in the type 2 diabetes group compared with the control group. Conclusion. Our results suggest that parotid salivary glucose has potential as a biomarker to monitor type 2DM and as a painless, noninvasive method for the management of type 2DM.

  6. Evaluation of Parotid Salivary Glucose Level for Clinical Diagnosis and Monitoring Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Beibei Wang

    2017-01-01

    Full Text Available Background. To investigate the relationships among blood glucose, mixed saliva glucose, and parotid glucose in type 2 diabetes patients and to evaluate the diagnostic and monitoring value of salivary gland glucose in patients with type 2 diabetes (type 2DM. Material and Methods. Thirty patients with type 2DM and 30 healthy age- and sex-matched individuals were included in this study. Glucose levels in unstimulated mixed saliva and in unstimulated parotid saliva were measured by the glucose oxidase peroxidase method. Results. The blood glucose and parotid salivary glucose levels in type 2DM patients were significantly higher than those in the controls (P<0.05. The blood glucose, parotid salivary glucose, and mixed salivary glucose were 7.46±1.44 mmol/L, 0.18±0.19 mmol/L, and 3.17×10-2±2.84×10-2 mmol/L, respectively, in the type 2DM group; the corresponding glucose levels in the control group were 5.56±0.71 mmol/L, 7.70×10-2±6.02×10-2 mmol/L, and 3.47×10-2±2.79×10-2 mmol/L. The parotid salivary and blood glucose levels in type 2DM patients were strongly correlated; the linear regression equation for blood glucose and parotid salivary glucose was Y=6.267X+6.360, with r=0.810. However, mixed salivary glucose levels were not significantly different in the type 2 diabetes group compared with the control group. Conclusion. Our results suggest that parotid salivary glucose has potential as a biomarker to monitor type 2DM and as a painless, noninvasive method for the management of type 2DM.

  7. Evaluation of the anti-osteoporotic effects of metformin and sitagliptin in postmenopausal diabetic women.

    Science.gov (United States)

    Hegazy, Sahar Kamal

    2015-03-01

    Osteoporosis is the most important metabolic bone disease in patients with diabetes mellitus. Several studies have documented that metformin is osteogenic in vitro. In contrast, others showed no effect of metformin on the osteogenic differentiation of bone marrow-derived mesenchymal stem cells. Incretin hormones have received much attention because of their beneficial effects beyond glycemia, including on bone health. The study evaluated the anti-osteoporotic effect of metformin and sitagliptin in postmenopausal diabetic women. Forty postmenopausal diabetic women were randomly divided into two equal groups. Group 1 received metformin (Glucophage(®) 500 mg) 1 tablet twice daily, and group 2 received sitagliptin (Januvia(®) 100 mg) 1 tablet/day, for 12 weeks. Fasting blood and urine samples were collected for measurement of serum total alkaline phosphatase (ALP), osteocalcin, and urinary deoxypyridinoline (DPD). Laboratory tests were measured at baseline, after 4 and 8 weeks, and at the end of the study. Bone mineral density of the anterior posterior lumbar spine was measured by dual energy X-ray absorptiometry at baseline and after 12 weeks of the intervention. In the metformin-treated group, the mean values for all markers of bone turnover at 12 weeks of treatment were not significantly different from baseline. In group 2, the mean serum total ALP was significantly decreased, serum osteocalcin levels were non-significantly decreased gradually by 10% at 12 weeks, while urinary DPD decreased significantly and was then maintained at 28% decrease at 12 weeks. In conclusion, metformin is neither osteogenic nor has anti-osteoporotic effect, while sitagliptin could positively regulate bone metabolism.

  8. The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management.

    Science.gov (United States)

    Househ, Mowafa S; Shubair, Mamdouh M; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

    2015-10-01

    The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers' ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Overall, the consumers' ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients.

  9. New Biguanides as Anti-Diabetic Agents, Part II: Synthesis and Anti-Diabetic Properties Evaluation of 1-Arylamidebiguanide Derivatives as Agents of Insulin Resistant Type II Diabetes.

    Science.gov (United States)

    Basyouni, Wahid M; Abbas, Samir Y; El Shehry, Mohamed F; El-Bayouki, Khairy A M; Aly, Hanan F; Arafa, Azza; Soliman, Mahmoud S

    2017-11-01

    New 1-arylamidebiguanide hydrochloride salts were synthesized via reaction of hydrazide derivatives with dicyandiamide in acidic medium. The structure of the obtained derivatives was characterized by spectroscopic and elemental analysis tools. The anti-diabetic properties of the synthesized compounds were determined. Oral treatment of hyperglycemic rats with the synthesized biguanide derivatives showed a significant decrease of the elevated glucose in comparison with the anti-diabetic standard drug, metformin. The effects of the synthesized biguanide derivatives on the diabetic properties regarding liver function enzyme activities (AST, ALT, and ALP), lipid profiles (TC, TG, and TL), lipid peroxide, and nitrous oxide as well as histopathological characteristics were investigated and discussed. © 2017 Deutsche Pharmazeutische Gesellschaft.

  10. Evaluation of a school-based diabetes education intervention, an extension of Program ENERGY

    Science.gov (United States)

    Conner, Matthew David

    Background: The prevalence of both obesity and type 2 diabetes in the United States has increased over the past two decades and rates remain high. The latest data from the National Center for Health Statistics estimates that 36% of adults and 17% of children and adolescents in the US are obese (CDC Adult Obesity, CDC Childhood Obesity). Being overweight or obese greatly increases one's risk of developing several chronic diseases, such as type 2 diabetes. Approximately 8% of adults in the US have diabetes, type 2 diabetes accounts for 90-95% of these cases. Type 2 diabetes in children and adolescents is still rare, however clinical reports suggest an increase in the frequency of diagnosis (CDC Diabetes Fact Sheet, 2011). Results from the Diabetes Prevention Program show that the incidence of type 2 diabetes can be reduced through the adoption of a healthier lifestyle among high-risk individuals (DPP, 2002). Objectives: This classroom-based intervention included scientific coverage of energy balance, diabetes, diabetes prevention strategies, and diabetes management. Coverage of diabetes management topics were included in lesson content to further the students' understanding of the disease. Measurable short-term goals of the intervention included increases in: general diabetes knowledge, diabetes management knowledge, and awareness of type 2 diabetes prevention strategies. Methods: A total of 66 sixth grade students at Tavelli Elementary School in Fort Collins, CO completed the intervention. The program consisted of nine classroom-based lessons; students participated in one lesson every two weeks. The lessons were delivered from November of 2005 to May of 2006. Each bi-weekly lesson included a presentation and interactive group activities. Participants completed two diabetes knowledge questionnaires at baseline and post intervention. A diabetes survey developed by Program ENERGY measured general diabetes knowledge and awareness of type 2 diabetes prevention strategies

  11. Kinetic Chemiluminescence as a Method for Oxidative Stress Evaluation in Examinations of Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Proskurnina, E V; Polimova, A M; Sozarukova, M M; Prudnikova, M A; Ametov, A S; Vladimirov, Yu A

    2016-05-01

    We propose a new approach to evaluation of oxidative stress based on kinetic chemiluminescence: measurement of antioxidant and pro-oxidant activities of the plasma. The study included 50 patients with type 2 diabetes mellitus receiving peroral hypoglycemic therapy. In addition to the above parameters, the levels of TBA-reactive products, inflammation markers, clotting parameters, and biochemical values were studied. The new method provides information on oxidative stress in patients with type 2 diabetes mellitus irrespective of the clinical and laboratory values. The use of this method in complex with the clinical, laboratory, and instrumental studies allows comprehensive evaluation of patient's status for the diagnosis and choice of therapy.

  12. Mobile Applications for Diabetics: A Systematic Review and Expert-Based Usability Evaluation Considering the Special Requirements of Diabetes Patients Age 50 Years or Older

    Science.gov (United States)

    Quade, Mandy; Kirch, Wilhelm

    2014-01-01

    Background A multitude of mhealth (mobile health) apps have been developed in recent years to support effective self-management of patients with diabetes mellitus type 1 or 2. Objective We carried out a systematic review of all currently available diabetes apps for the operating systems iOS and Android. We considered the number of newly released diabetes apps, range of functions, target user groups, languages, acquisition costs, user ratings, available interfaces, and the connection between acquisition costs and user ratings. Additionally, we examined whether the available applications serve the special needs of diabetes patients aged 50 or older by performing an expert-based usability evaluation. Methods We identified relevant keywords, comparative categories, and their specifications. Subsequently, we performed the app review based on the information given in the Google Play Store, the Apple App Store, and the apps themselves. In addition, we carried out an expert-based usability evaluation based on a representative 10% sample of diabetes apps. Results In total, we analyzed 656 apps finding that 355 (54.1%) offered just one function and 348 (53.0%) provided a documentation function. The dominating app language was English (85.4%, 560/656), patients represented the main user group (96.0%, 630/656), and the analysis of the costs revealed a trend toward free apps (53.7%, 352/656). The median price of paid apps was €1.90. The average user rating was 3.6 stars (maximum 5). Our analyses indicated no clear differences in the user rating between free and paid apps. Only 30 (4.6%) of the 656 available diabetes apps offered an interface to a measurement device. We evaluated 66 apps within the usability evaluation. On average, apps were rated best regarding the criterion “comprehensibility” (4.0 out of 5.0), while showing a lack of “fault tolerance” (2.8 out of 5.0). Of the 66 apps, 48 (72.7%) offered the ability to read the screen content aloud. The number of

  13. Mobile applications for diabetics: a systematic review and expert-based usability evaluation considering the special requirements of diabetes patients age 50 years or older.

    Science.gov (United States)

    Arnhold, Madlen; Quade, Mandy; Kirch, Wilhelm

    2014-04-09

    A multitude of mhealth (mobile health) apps have been developed in recent years to support effective self-management of patients with diabetes mellitus type 1 or 2. We carried out a systematic review of all currently available diabetes apps for the operating systems iOS and Android. We considered the number of newly released diabetes apps, range of functions, target user groups, languages, acquisition costs, user ratings, available interfaces, and the connection between acquisition costs and user ratings. Additionally, we examined whether the available applications serve the special needs of diabetes patients aged 50 or older by performing an expert-based usability evaluation. We identified relevant keywords, comparative categories, and their specifications. Subsequently, we performed the app review based on the information given in the Google Play Store, the Apple App Store, and the apps themselves. In addition, we carried out an expert-based usability evaluation based on a representative 10% sample of diabetes apps. In total, we analyzed 656 apps finding that 355 (54.1%) offered just one function and 348 (53.0%) provided a documentation function. The dominating app language was English (85.4%, 560/656), patients represented the main user group (96.0%, 630/656), and the analysis of the costs revealed a trend toward free apps (53.7%, 352/656). The median price of paid apps was €1.90. The average user rating was 3.6 stars (maximum 5). Our analyses indicated no clear differences in the user rating between free and paid apps. Only 30 (4.6%) of the 656 available diabetes apps offered an interface to a measurement device. We evaluated 66 apps within the usability evaluation. On average, apps were rated best regarding the criterion "comprehensibility" (4.0 out of 5.0), while showing a lack of "fault tolerance" (2.8 out of 5.0). Of the 66 apps, 48 (72.7%) offered the ability to read the screen content aloud. The number of functions was significantly negative correlated

  14. Evaluation of preference for a novel durable insulin pen with memory function among patients with diabetes and health care professionals

    Directory of Open Access Journals (Sweden)

    Klausmann G

    2013-04-01

    Full Text Available Gerhard Klausmann,1 Irene Hramiak,2 Marianne Qvist,3 Kristian Handberg Mikkelsen,3 Xiaohui Guo4 1Internal Medicine Diabetology Practice, Aschaffenburg, Germany; 2Division of Endocrinology and Metabolism, St Joseph's Healthcare, London, Ontario, Canada; 3Novo Nordisk A/S, Soeborg, Denmark; 4Department of Endocrinology, Peking University First Hospital, Beijing, People's Republic of China Background: Improving adherence to insulin treatment for better glycemic control remains a challenge in the management of diabetes. New technological aids are required to help support adherence. This study evaluated preference for the NovoPen® 5 (NP5, a durable insulin pen with memory function, compared with the HumaPen Luxura® (HPL among patients with diabetes and health care professionals. Methods: This crossover, multicenter usability study included insulin pen-experienced patients with diabetes and health care professionals treating patients with diabetes in Canada, China, and Germany. Participants evaluated NP5 and HPL in a randomized order by performing handling tasks in a usability test related to everyday use during a face-to-face interview. Tasks, pens, and preferences were assessed by completing a questionnaire comprised of rating and open-ended questions relating to confidence in everyday diabetes management. Results: Overall, 300 patients with diabetes and 150 health care professionals participated in the study. Significantly more participants preferred NP5 (81% to HPL (18% (P < 0.001. Also, 82% of patients with diabetes had more confidence in NP5 for managing their daily injections versus 11% with HPL (P < 0.001, and 7% had no preference. Memory function was most helpful in giving patients with diabetes confidence about when they last injected (63%, how much insulin they last injected (62% and improving diabetes management (55%. Participants gave higher ratings to NP5 than to HPL on all parameters relating to performing an injection (ease of

  15. Kedrostis Medik. in Asia

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    W.J.J.O. De Wilde

    2013-04-01

    Full Text Available DE WILDE, W.J.J.O.  & DUYFJES, BRIGITTA E.E. 2004. Kedrostis Medik. in Asia. Reinwardtia 12(2:129 – 133. — Kedrostis (Cucurbitaceae occurs in Africa and Madagascar and comprises 4 (5 species in Asia. Of these 2 species are found in India and Sri Lanka and 2 (3 species in western Malesia. One Malesian species is for the first time included in Kedrostis here, Kedrostis bennettii (Miq. W.J. de Wilde & Duyfjes, and one species is described as new here, Kedrostis hirta W.J. de Wilde & Duyfjes. One more Malesian species is insufficiently known to be formally described.  Keywords: Kedrostis, Cucurbitaceae, SE Asia, taxonomy

  16. Accuracy of a technology-assisted eye exam in evaluation of referable diabetic retinopathy and concomitant ocular diseases.

    Science.gov (United States)

    Conlin, Paul R; Asefzadeh, Baharak; Pasquale, Louis R; Selvin, Gerald; Lamkin, Rebecca; Cavallerano, Anthony A

    2015-12-01

    Digital retinal imaging using store-and-forward technology is used to screen for diabetic retinopathy (DR). Its usefulness in detecting non-diabetic eye diseases is uncertain. We determined the level of agreement between teleretinal imaging supplemented with visual acuity and intraocular pressure (IOP) measurements (ie, technology-assisted eye (TAE) exam) and a comprehensive eye exam in evaluation for DR and non-diabetic ocular conditions. We conducted a prospective, observational study with two parallel evaluations. Patients with diabetes (n=317) had a TAE exam and a comprehensive eye exam on the same day. A subset of participants with normal baseline exams (n=72) had follow-up exams 1 year later. We measured the level of agreement for referable ocular findings. Agreement for referable ocular findings was moderate (n=389, agreement: 77%; κ: 0.55), due in part to ungradable exams (22%). However, about half of the ungradable exams had findings that warranted referral. There was substantial agreement for follow-up exams (n=72, agreement: 93%; κ: 0.63). Among all gradable exams (n=303), the TAE exam had 86% sensitivity and 84% specificity for referable ocular findings, with high agreement (≥94%) for DR and other major ocular diagnoses. There was moderate-to-substantial agreement between a TAE exam and a comprehensive eye exam for referable ocular findings in patients with diabetes. Ungradable exams were a frequent marker of ocular pathology. Teleretinal imaging may be a useful evaluation for both diabetic and non-diabetic ocular conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Epilepsy: Asia versus Africa.

    Science.gov (United States)

    Bhalla, Devender; Tchalla, Achille Edem; Marin, Benoît; Ngoungou, Edgard Brice; Tan, Chong Tin; Preux, Pierre-Marie

    2014-09-01

    Is epilepsy truly an "African ailment"? We aimed to determine this, since international health agencies often refer to epilepsy as an African disease and the scientific literature has spoken the same tone. Various published materials, mainly reports, articles, were used to gather Asian and African evidence on various aspects of epilepsy and many of its risk and associated factors. Our results suggest that in no way can epilepsy be considered as an African ailment and such characterization is most likely based on popular beliefs rather than scientific evidence. In comparison to Africa, Asia has a 5.0% greater burden from all diseases, and is 17.0% more affected from neuropsychiatric disorders (that include epilepsy). Given that more countries in Asia are transitioning, there may be large demographic and lifestyle changes in the near future. However these changes are nowhere close to those expected in Africa. Moreover, 23 million Asians have epilepsy in comparison to 3.3 million Africans and 1.2 million sub-Saharan Africans. In comparison to Africa, Asia has more untreated patients, 55.0% more additional epilepsy cases every year, because of its larger population, with greater treatment cost and possibly higher premature mortality. Of several associated factors discussed herein, many have more importance for Asia than Africa. The current state of epilepsy in Asia is far less than ideal and there is an urgent need to recognize and accept the importance of epilepsy in Asia. In no way can epilepsy be considered as an African ailment. This is most likely based on popular beliefs rather than scientific evidence. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  18. A dual enzymatic-biosensor for simultaneous determination of glucose and cholesterol in serum and peritoneal macrophages of diabetic mice: Evaluation of the diabetes-accelerated atherosclerosis risk

    Energy Technology Data Exchange (ETDEWEB)

    Huang Qilin; An Yarui; Tang Linlin; Jiang Xiaoli; Chen Hua; Bi Wenji [Department of Chemistry, East China Normal University, Shanghai 200062 (China); Wang Zhongchuan [Department of Anorectal Surgery, Xinhua Hospital, Affiliated to School of Medicine of Shanghai Jiaotong University, Shanghai 200092 (China); Zhang Wen, E-mail: wzhang@chem.ecnu.edu.cn [Department of Chemistry, East China Normal University, Shanghai 200062 (China)

    2011-11-30

    Graphical abstract: In this paper, we reported a novel dual enzymatic-biosensor for simultaneous determination of glucose and cholesterol in serum and peritoneal macrophages (PMs) of diabetic mice to evaluate the diabetes-accelerated atherosclerosis risk. The biosensor was firstly modified with a poly-thionine (PTH) film as electron transfer mediator (ETM), then the gold nanoparticles (GNPs) were covered on the surface of PTH to act as tiny conduction centers for facilitating the electron transfer between enzymes and electrode. The schematic of the dual biosensor is shown in figure. The developed dual biosensor had good electrocatalytic activity toward the oxidations of glucose and cholesterol, exhibited a linear range from 0.008 mM to 6.0 mM for glucose with a detection limit of 2.0 {mu}M, and a linear range from 0.002 mM to 1.0 mM for cholesterol with a detection limit of 0.6 {mu}M. The results of the diabetic mice demonstrated that the cholesterol level was not changed obviously with the increase of glucose level in serum, while the cholesterol level was enhanced together with the increase of the glucose level in PMs. Previous studies have shown that the large accumulation of cholesterol in macrophage could lead to macrophage foam cell formation, the hallmark of early atherosclerosis. These findings indicated the possibility that high glucose induced by diabetes might increase the macrophage cholesterol level to further accelerate atherosclerosis development. Highlights: Black-Right-Pointing-Pointer A novel biosensor was developed to determine glucose and cholesterol simultaneously. Black-Right-Pointing-Pointer The dual enzymatic-biosensor has good selectivity and high sensitivity. Black-Right-Pointing-Pointer We determined glucose and cholesterol in the real samples of diabetic mice. Black-Right-Pointing-Pointer The results showed that high glucose might increase the macrophage cholesterol level. Black-Right-Pointing-Pointer It provided useful experimental

  19. Evaluation of salivary glucose, amylase, and total protein in Type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    M Indira

    2015-01-01

    Conclusion: These results suggest that diabetes influences the composition of saliva. Since a significant correlation was not observed between salivary and blood glucose levels, further research is needed to determine salivary glucose estimation as a diagnostic tool for diabetes mellitus.

  20. Glycated Albumin – More Than the Missing Link in the Evaluation of Diabetes Control

    Directory of Open Access Journals (Sweden)

    Dinu Ilie-Robert

    2014-06-01

    Full Text Available Diabetes mellitus represents a major public health problem in the world and glycemic control is very important in subjects with diabetes. Glycation of many proteins is increased in subjects with diabetes compared with persons without diabetes. Glycated albumin (GA has emerged as a possible glycation index for intermediate-term diabetes control. There is evidence that GA can be considered a better parameter than glycated haemoglobin in many conditions including pregnancy, chronic kidney disease, liver diseases and anemia. Several reports indicate that GA plays a role in the pathogeny of diabetes complications, mainly in diabetic nephropathy and retinopathy. There are several limitations for using GA including the lack of standardization in the laboratories. Several studies are needed in order to understand the place of GA in the pathogeny of diabetes complications and the role in assessing the metabolic control

  1. Evaluation of the Association Metformin: Plantago ovata Husk in Diabetic Rabbits.

    Science.gov (United States)

    Díez-Láiz, Raquel; García-Vieitez, Juan J; Diez-Liébana, M José; Sierra-Vega, Matilde; Sahagún-Prieto, Ana M; Calle-Pardo, Ángela P; Fernández-Martínez, Nélida

    2015-01-01

    In this experimental study we have investigated whether the inclusion of the dietary fiber Plantago ovata husk could be recommended as coadjuvant in treatments with oral hypoglycemic drugs. We evaluated the use of Plantago ovata husk-metformin association in diabetic rabbits by determining its effects on glucose and insulin concentrations. Six groups of 6 rabbits were used. Groups 1 to 3 were fed with standard chow and groups 4 to 6 with chow supplemented with Plantago ovata husk (3.5 mg/kg/day). Two groups (numbers 1 and 4) were used as controls (receiving standard or supplemented chow), two groups (numbers 2 and 5) received metformin orally, and the other two (numbers 3 and 6) were treated orally with metformin and psyllium. Plasma glucose concentrations were lower in groups fed with fiber-supplemented chow whereas insulin levels showed important interindividual variations. Glucose pharmacokinetics parameters showed significant differences in Cmax and t(max) in relation to fiber intake. Insulin pharmacokinetics parameters after treatment with oral metformin showed an important increase in Cmax, AUC, and t(max) in animals fed with fiber. We conclude that Plantago ovata husk intake can contribute to the oral antihyperglycemic treatment of type 2 diabetes.

  2. Evaluation of knowledge regarding gestational diabetes mellitus and its association with glycaemic level: A Malaysian study.

    Science.gov (United States)

    Hussain, Zahid; Yusoff, Zuraidah Mohd; Sulaiman, Syed Azhar Syed

    2015-06-01

    The aim of this study was to evaluate the knowledge about GDM and its corresponding relation with glycaemic level in GDM patients. A cross-sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June 2013 to December 2013 using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) on the sample of 175 GDM patients. Three most recent fasting plasma glucose (FPG) values (mmol/l) were taken from patients profiles and mean was calculated. A total of 166 patients were included in final analysis. A total mean knowledge score of 166 patients was 10.01±3.63 and total mean FPG value was 5.50±1.13. Knowledge had a significant negative association with FPG (r=- 0.306, Pknowledge domains, highest mean score was seen for diet/food values domain and lowest for management of GDM. Educational level seems to be the most significant predictor of GDM knowledge and glycaemic control. Highest mean knowledge score and lowest mean glycaemic levels were recorded for patients aged 25-29 years, Malay ethnicity, working women and family history of DM. Higher Knowledge about GDM is related to better glycaemic control. New educational strategies should be developed to improve the lower health literacy. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  3. Evaluation of the Association Metformin: Plantago ovata Husk in Diabetic Rabbits

    Directory of Open Access Journals (Sweden)

    Raquel Díez-Láiz

    2015-01-01

    Full Text Available In this experimental study we have investigated whether the inclusion of the dietary fiber Plantago ovata husk could be recommended as coadjuvant in treatments with oral hypoglycemic drugs. We evaluated the use of Plantago ovata husk-metformin association in diabetic rabbits by determining its effects on glucose and insulin concentrations. Six groups of 6 rabbits were used. Groups 1 to 3 were fed with standard chow and groups 4 to 6 with chow supplemented with Plantago ovata husk (3.5 mg/kg/day. Two groups (numbers 1 and 4 were used as controls (receiving standard or supplemented chow, two groups (numbers 2 and 5 received metformin orally, and the other two (numbers 3 and 6 were treated orally with metformin and psyllium. Plasma glucose concentrations were lower in groups fed with fiber-supplemented chow whereas insulin levels showed important interindividual variations. Glucose pharmacokinetics parameters showed significant differences in Cmax and tmax in relation to fiber intake. Insulin pharmacokinetics parameters after treatment with oral metformin showed an important increase in Cmax, AUC, and tmax in animals fed with fiber. We conclude that Plantago ovata husk intake can contribute to the oral antihyperglycemic treatment of type 2 diabetes.

  4. Isolated polyhydramnios in the third trimester: is a gestational diabetes evaluation of value?

    Science.gov (United States)

    Frank Wolf, Maya; Peleg, David; Stahl-Rosenzweig, Talia; Kurzweil, Yaffa; Yogev, Yariv

    2017-11-01

    We evaluated implications of testing for gestational diabetes mellitus (GDM) in pregnancies complicated by third trimester isolated polyhydramnios with previous negative diabetes screening test. In this retrospective cohort study of 104 pregnant women with polyhydramnios between 2005 and 2013, all had normal first trimester fasting glucose and normal glucose challenge test (GCT polyhydramnios, one abnormal value in the oral glucose tolerance test (OGTT) was identified in four additional women (3.8%). No significant differences were found in risk factors for GDM, mean second trimester GCT (117.5 vs. 107.2 mg/dL, p = 0.38) or fasting glucose values (82 vs. 86 mg/dL, p = 0.29) between women in the polyhydramnios group with and without late GDM diagnosis. Moreover, no significant difference was found in relation to the mode of delivery or birth weight between the studied groups (3437 ± 611 vs. 3331 ± 515 g, p = 0.63). Diagnosis of third trimester polyhydramnios was not associated with increased risk for GDM or neonatal complications.

  5. Initial experience and evaluation of reusable insulin pen devices among patients with diabetes in emerging countries.

    Science.gov (United States)

    Tschiedel, Balduino; Almeida, Oscar; Redfearn, Jennifer; Flacke, Frank

    2014-12-01

    Many individuals with type 2 diabetes in emerging countries are transitioning from vial-and-syringe insulin delivery to that of insulin pens (disposable or reusable). As with all insulin delivery methods, patient preferences and comfort are of utmost importance to optimize adherence to treatment. Patient-preferred characteristics for reusable insulin pens and barriers to appropriate injection, particularly in these regions, have not been widely reported in the clinical literature, highlighting a key information gap for clinicians considering these methods as part of a comprehensive diabetes management approach. Face-to-face interviews were conducted with people with type 1/2 diabetes, including insulin-naïve and established insulin users. After moderator demonstration, participants were evaluated on their ability to perform a six-step process to inject a 10-unit dose into a pad with the AllStar(®) (AS; Sanofi, Mumbai, India), HumaPen Ergo II(®) (HE2; Eli Lilly, Indianapolis, USA), and NovoPen 4(®) (NP4; Novo Nordisk, Bagsværd, Denmark) pens. Local pens were also tested in India, China and Brazil. A total of 503 people from India, Malaysia, Brazil, Egypt, and China participated. Participants completed the six-step process in an average, 2-3 min per pen. Participants ranked ease of overall use and ease of self-injection and dialing/reading dose as most important features for new insulin pens. When using the pens, the most difficult step was priming/safety testing, with 7-12% failing and 28-40% having difficulty; 6%, 18%, and 22% failed to hold the injection button down for the required period of time using AS, NP4, and HE2, respectively. Participants ranked AS significantly higher for nine of 12 ease-of-use features including three of the top four features considered the most important for reusable pens, while HE2 was ranked higher for two features. Local pens were ranked lowest. Priming the pen and injecting the dose imparted most difficulty for people with

  6. [Evaluate the effectiveness of laser therapy in the treatment of diabetic maculopathy].

    Science.gov (United States)

    Mrugacz, Małgorzata; Krajewska, Marzena; Bryl, Anna; Szuszkiewicz, Maciej

    2013-06-01

    Diabetes mellitus concerns a growing number of people in the world. Its complications are an important social problem. Diabetic macular edema (DME) is one of the leading causes of visual loss in the course of the disease. Deterioration of vision is typically the patients with long-standing, poorly controlled diabetes, both type 1 and 2. DME can occur at any stage of the disease. Because structural changes in the macula are reversible in the initial period, it is important to start treatment early. In the treatment of diabetic uses three techniques retinal laser--direct photocoagulation, photocoagulation a "grid" and the panphotocoagulation. The aim of this study was to evaluate the effectiveness of laser therapy in the treatment of diabetic macular edema. The study included 90 patients (180 eyes) with DME, 50 women and 40 men aged from 18 to 80 years with a visual acuity of 0.08 to 0.7 with the best corrected on the Snellen chart. 9 people were with type 1 diabetes, 81 with type 2. 86 patients applied insulin, 4 people took drugs. Eye with poor visual acuity was qualified for the treatment. In all patients enrolled in the study visual acuity, anterior segment of the eye in the slit lamp and fundus by indirect ophthalmoscopy with Volk 78D lens were evaluated. DME was diagnosed on the basis of the results of fluorescein angiography and optical coherence tomography. In the patients laser therapy was performed twice: on day 1 after qualification and four months later. Performed two types of laser: the focal photocoagulation and the type of "grid" depending on the severity of DME. Retinal photocoagulation was performed using a diode laser 810 nm Diode Laser Systems OcuLight SL and SLx Iris Medical Models. Patients were monitored at 4 and 8 months after the laser therapy. The results were statistically analyzed. Duration of diabetes less than 10 years was in 67 patients, over 10 years in 23. In patients with diabetes under 10 years predominated limited type of macular

  7. Is Central Asia really exsiccating?

    Science.gov (United States)

    Aizen, V. B.; Aizen, E. M.; Surazakov, A. B.

    2008-12-01

    At the end of 20th and the beginning of 21st century central Asia oases suffered from serious drought caused lack of water for agriculture, economy growth and population increase. However, people of this region always experienced lack of water for irrigation and fought a war over the rights to control river streams. The drying up of central Asian rivers is not a new phenomenon according to the ancient manuscripts. Thus, lets see about what has happened with the past century climate and water resources of central Asia using the long-term observational data. We analyzed data from more than 200 meteorological stations and stream gauges over the central Asia in elevation range from 25 m. b.s.l. to 4,000 m. a.s.l. to understand the last 100 years variability in climate and water resources, examining changes in the extreme and mean monthly air temperatures, precipitation and river runoff. The evaluation of seasonal snow and glacier's covered areas between 1970th and 2007th in central Asia derived from AVHRR, MODIS, Hexagon KH-9, Landsat ETM and ASTER data exhibit 15% reduction of the seasonal snow covered area and 10.1% of the glacier area. It has been found that during last twenty years the duration of snowmelt, from the date of maximum snow cover to date of its disappearance, reduced by 30 days and in 2007 was equal to 138 days in the central Asian mountains. The decrease of seasonal snow cover is not a linear process. The further decrease may be accelerated due to increase of rainfall instead of snowfall in early spring months at high elevations, and consequently a lesser heat expenditure for the snowmelt. The growth in summer air temperatures, especially observable since the 1970th, accompanied by increase of evapotranspiration and precipitation, notably in summer and autumn, and at high elevations over 3,000 m, and at the western peripheral mountain ridges. Average difference in the means of annual air temperatures for the two thirty-year periods before and after

  8. Promising Role of Exfoliative Cytology in the Evaluation of Glycaemic Status of Type II Diabetics: A Pilot Study.

    Science.gov (United States)

    Satpathy, Yasmin; Kumar, Praveen S; Singh, Navneet

    2015-06-01

    The degree of metabolic control in diabetes mellitus influences the susceptibility of patients to oral diseases. It is mandatory to regularly monitor glycaemic status, however invasive methods may be contraindicated or intolerable to diabetic individuals. Thus, cytology, being a simple, non-invasive and rapid procedure, is a promising protocol for assessing diabetic status and assisting in management. To assess the number of PAS positive glycogen containing cells and associated cellular changes in buccal smears of type II diabetics and correlate the findings with their serum glucose levels. The study was conducted at the out patient Department of Oral and Maxillofacial Pathology, KLES Institute of Dental Sciences, Belgaum. Fifty known cases of type II diabetes mellitus and 50 healthy individuals were included in the study. Fasting blood glucose levels were estimated and buccal smears stained with Periodic Acid Schiff stain. The observed cellular changes were correlated with the glycaemic status of each patient. Statistical evaluations such as Student's t test (P Cytological findings and clinical observations, suggest a correlation between the extent of these changes and clinical parameters like glycaemic control. Further studies in this aspect can help in improving the reliability of oral cytology as a diagnostic tool in diabetes.

  9. An evaluation framework and a pilot study of a mobile platform for diabetes self-management: insights from pediatric users.

    Science.gov (United States)

    Padman, Rema; Jaladi, Sravani; Kim, Sean; Kumar, Saumitra; Orbeta, Philip; Rudolph, Kate; Tran, Tony

    2013-01-01

    According to WHO, pediatric diabetes is a rising global public health problem, with increasing impact on developing nations. This study summarizes a multidimensional, scalable pilot evaluation of a diabetes self-management platform combining mobile technology with social networking to capture four key metrics of Type 1 diabetes self-management, associated social interactions, and gaming features providing targeted feedback to 8 pediatric users. Based on their 2-month interaction with the application, we analyze click-stream data from social interactions, key health metrics, text comments, and usability and satisfaction surveys to evaluate engagement with the platform and effectiveness in controlling blood glucose using a product-process-program framework. Our preliminary results indicate that this framework was successful in demonstrating the potential of the mobile health platform to effectively leverage the growing use of mobile applications and social media to present a unique benefit that engaged pediatric users and provided useful insights for self-health management.

  10. Evaluation of Diabetes Quality of Care Based on a Care Scoring System among People Referring to Diabetes Clinic in Ardabil, 2014

    Directory of Open Access Journals (Sweden)

    J Ataei

    2015-06-01

    Full Text Available Background & objectives: Successful implementation of diabetes care can reduce acute and chronic complications of diabetes. This study was conducted to evaluate the quality of care according to a care scoring system among people with type 2 diabetes referring to the diabetes clinic in Ardabil. Methods: This cross sectional study was conducted in 2014 and a total of 300 people with type 2 diabetes in age range of 20-70 years old were included via convenience sampling. Data were collected by an interviewer using a structured questionnaire and checklist. Each patient was classified according to a quality of care scoring system into 3 categories: ≤10, 15-20, >20. Statistical analysis performed by SPSS v.20 software and descriptive analysis used to display data as frequency tables and graphs. Analytical tests such as ANOVA, Kruskal-Wallis, Chi squared, and fisher exact test were also used to analyze the data. Results: The mean age of patients was 54.13 ± 9.13 and the majority of them were women (72.3%. The mean of BMI and HbA1c was 29.58 ± 4.77 and 8.93± 2.13, respectively. The mean of FBS was 191.18 ± 84.23 and the average length of disease was 7.74±5.89 years. The mean of quality of care score among participants was 23.20±9.99. About one-third of patients (29.7% had a quality care score ≤10, half of them (51% had a score between 15-20, and only 19.35% had a score >20. There was an association between HbA1c, FBS, diastolic blood pressure, cholesterol and LDL with a quality of care score which was statistically significant (p<0.05. Conclusion: In this study there was a gap between the current quality of care of patients and recommended standards. Therefore in order to minimize the current barriers and problems it is recommended to implement an effective interventional program. In addition, using a quality care scoring system is a rapid, easy and valid method for evaluating diabetes quality of care.

  11. Evaluation of a type 1 diabetes serum cohort by SELDI-TOF MS protein profiling

    DEFF Research Database (Denmark)

    Albrethsen, Jakob; Kaas, Anne; Schönle, Eugen

    2009-01-01

    -2002). Samples collected 1 (n = 270), 6 (n = 248), and 12 (n = 248) months after T1D diagnosis were grouped across centers and compared. The serum protein profiles varied with collection site and day of analysis; however, markers of sample processing were not systematically different between samples collected......Proteomics analysis of serum from patients with type 1 diabetes (T1D) may lead to novel biomarkers for prediction of disease and for patient monitoring. However, the serum proteome is highly sensitive to sample processing and before proteomics biomarker research serum cohorts should preferably...... be examined for potential bias between sample groups. SELDI-TOF MS protein profiling was used for preliminary evaluation of a biological-bank with 766 serum samples from 270 patients with T1D, collected at 18 different paediatric centers representing 15 countries in Europe and Japan over 2 years (2000...

  12. Formulation and evaluation of bilayer tablet by using melt granulation technique for treatment of diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dhruvita Patel

    2012-01-01

    Full Text Available The objective of present study was to prepare and characterize Bilayer tablet formulation containing Metformin HCl in extended release matrix form and Pioglitazone HCl in immediate release form for the treatment of diabetes mellitus. Different formulations containing Metformin HCl were manufactured using 3 2 factorial designs. Influence of hydrophilic carrier, hydrophobic polymer on drug release was studied. Immediate release layer of Pioglitazone was optimized using different super disintegrants. All formulations were evaluated for percentage drug release. Optimization results indicated that release rate of Metformin is directly proportional to the levels of Eudragit S 100 and PEG 6000. Results confirmed that Bilayer tablet formulation containing extended release of Metformin HCl and immediate release of Pioglitazone HCl could be developed by using melt granulation technique.

  13. Cardiac sympathetic innervation assessed with (123)I-MIBG retains prognostic utility in diabetic patients with severe left ventricular dysfunction evaluated for primary prevention implantable cardioverter-defibrillator.

    Science.gov (United States)

    García-González, P; Fabregat-Andrés, Ó; Cozar-Santiago, P; Sánchez-Jurado, R; Estornell-Erill, J; Valle-Muñoz, A; Quesada-Dorador, A; Payá-Serrano, R; Ferrer-Rebolleda, J; Ridocci-Soriano, F

    2016-01-01

    Scintigraphy with iodine-123-metaiodobenzylguanidine ((123)I-MIBG) is a non-invasive tool for the assessment of cardiac sympathetic innervation (CSI) that has proven to be an independent predictor of survival. Recent studies have shown that diabetic patients with heart failure (HF) have a higher deterioration in CSI. It is unknown if (123)I-MIBG has the same predictive value for diabetic and non-diabetic patients with advanced HF. An analysis is performed to determine whether CSI with (123)I-MIBG retains prognostic utility in diabetic patients with HF, evaluated for a primary prevention implantable cardioverter-defibrillator (ICD). Seventy-eight consecutive HF patients (48 diabetic) evaluated for primary prevention ICD implantation were prospectively enrolled and underwent (123)I-MIBG to assess CSI (heart-to-mediastinum ratio - HMR). A Cox proportional hazards multivariate analysis was used to determine the influence of (123)I-MIBG images for prediction of cardiac events in both diabetic and non-diabetic patients. The primary end-point was a composite of arrhythmic event, cardiac death, or admission due to HF. During a mean follow-up of 19.5 [9.3-29.3] months, the primary end-point occurred in 24 (31%) patients. Late HMR was significantly lower in diabetic patients (1.30 vs. 1.41, p=0.014). Late HMR≤1.30 was an independent predictor of cardiac events in diabetic (hazard ratio 4.53; p=0.012) and non-diabetic patients (hazard ratio 12.31; p=0.023). Diabetic patients with HF evaluated for primary prevention ICD show a higher deterioration in CSI than non-diabetics; nevertheless (123)I-MIBG imaging retained prognostic utility for both diabetic and non-diabetic patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  14. Literature of Southeast Asia.

    Science.gov (United States)

    Echols, John M.

    This paper provides a brief description of the literature of Southeast Asia. This area, which embraces the region south of China and east of India, includes the modern nations of Burma, Thailand, Cambodia, Laos, Vietnam, The Philippines, Malaysia and Indonesia. The earliest historical influence came from India around the beginnings of the…

  15. Social Capital in Asia

    DEFF Research Database (Denmark)

    Li, Peter Ping; Redding, Gordon

    2014-01-01

    This article provides an overview of social capital in Asia. Social capital is trust and appears in two main forms: relational, based on societal norms, and systemic, based on societal institutions. The relational encourages personalistic transactions; and systemic trust, supports more formal...

  16. Evaluation of an Urban Phase of the Specialized Care Program for Diabetes in Iran: Providers′ Perspectives

    Directory of Open Access Journals (Sweden)

    Hamid Ravaghi

    2014-01-01

    Full Text Available Background: To develop and implement more effective programs of health care delivery to prevent and control diabetes, Iran has developed and implemented the urban phase of the specialized care program for diabetic′s patients. Deeply understanding the views and experiences of various stakeholders in this program can assist policy makers to identify the program′s strengths and weaknesses and enable them to develop action plans. Hence, the present study aimed to evaluate the planning and establishing of this program from the perspective of providers. Methods: A qualitative study was applied using documents review and face-to-face semi-structured interviews with the program leads and relevant executive managers of the local medical universities. Thematic analysis was used to analyze the data. Results: Three main themes and nine subthemes were explored, including program planning (the content and the strengths, weaknesses, and corrective measures, implementation (executive mechanisms at the university level, establishment of referral system, collaboration between deputies of health and treatment, information dissemination mechanisms, satisfaction measurement and strengths, weaknesses and corrective measures, and result (implementation results. Conclusions: The urban phase of the specialized care program for diabetic′s patients has been a good base to improve continuity of care, which emphasizes on controlling and prevention of occurrence or progression of chronic complications of diabetes. This model can also be used for better management of other chronic disease. However, there are still issues that should be considered and improved such as allocation of guaranteed resources, more trained health professionals, and more evidence based guidelines and protocols, better collaboration among medical universities′ deputies, clearer payment system for program evaluation and better information management system.

  17. Meeting Asia's future gas import demand with stranded natural gas from central Asia, Russia, Southeast Asia, and Australia

    Science.gov (United States)

    Attanasi, E.D.; Freeman, P.A.

    2013-01-01

    This analysis shows the important contribution that stranded gas from central Asia, Russia, Southeast Asia, and Australia can make in meeting the projected demand for gas imports of China, India, Japan, and South Korea from 2020 to 2040. The estimated delivered costs of pipeline gas from stranded fields in Russia and central Asia at Shanghai, China, are generally less than delivered costs of liquefied natural gas (LNG). Australia and Malaysia are initially the lowest-cost LNG suppliers. In the concluding section, it is argued that Asian LNG demand is price sensitive, and that current Asian LNG pricing procedures are unlikely to be sustainable for gas import demand to attain maximum potential growth. Resource volumes in stranded fields evaluated can nearly meet projected import demands.

  18. Games and Diabetes: A Review Investigating Theoretical Frameworks, Evaluation Methodologies, and Opportunities for Design Grounded in Learning Theories.

    Science.gov (United States)

    Lazem, Shaimaa; Webster, Mary; Holmes, Wayne; Wolf, Motje

    2015-09-02

    Here we review 18 articles that describe the design and evaluation of 1 or more games for diabetes from technical, methodological, and theoretical perspectives. We undertook searches covering the period 2010 to May 2015 in the ACM, IEEE, Journal of Medical Internet Research, Studies in Health Technology and Informatics, and Google Scholar online databases using the keywords "children," "computer games," "diabetes," "games," "type 1," and "type 2" in various Boolean combinations. The review sets out to establish, for future research, an understanding of the current landscape of digital games designed for children with diabetes. We briefly explored the use and impact of well-established learning theories in such games. The most frequently mentioned theoretical frameworks were social cognitive theory and social constructivism. Due to the limitations of the reported evaluation methodologies, little evidence was found to support the strong promise of games for diabetes. Furthermore, we could not establish a relation between design features and the game outcomes. We argue that an in-depth discussion about the extent to which learning theories could and should be manifested in the design decisions is required. © 2015 Diabetes Technology Society.

  19. EVALUATION OF GLYCEMIA AT THE LEVEL OF SULCULAR AND CAPILLARY BLOOD IN DIABETIC PATIENTS WITH PERIODONTAL DISEASES

    Directory of Open Access Journals (Sweden)

    Maria Alexandra MARTU

    2013-12-01

    Full Text Available Scope of the study: A reliable, rapid and non-invasive evaluation of the patients suffering from diabetes mellitus through investigation of glycemia from the sulcular (crev‑ icular gingival blood. Materials and method: Laboratory investigations were made for evaluating the glycemia from the capillary (CBGL and crevicular (SBGL blood in 60 patients with periodontitis (30 suffering from diabetes, 30 non-diabetics, the obtained data being analyzed statisti‑ cally. Results: The mean values of glycemia (at both MSBG-sulcular and MCBG-capillary level, expressed in mg/dl, were of 168.60 and, respectively, 190.57. The MCBG level was of 269.73 for the group with diabetes and of 111.40 for the non-diabetic ones, respectively, whereas the MSBG level was of 240.217 for the first group and of 97.03 for the second one. An important correlation could be also observed between the levels of these values and the degree of periodontal affection. Conclusions: Testing of sulcular blood may represent an adequate, rapid and reliable method for the identification of patients affected with dia‑ betes, permitting to recommend a new screening protocol.

  20. Evaluation of sexual function in women with type 2 diabetes mellitus.

    Science.gov (United States)

    Fatemi, Seyedeh Seddigeh; Taghavi, Seyed Morteza

    2009-01-01

    Sexual health is an important, but often neglected, component of diabetes care. In contrast to erectile dysfunction among men with diabetes, female sexual dysfunction has not been well studied among diabetic women. The aim of this study was to assess the prevalence of sexual dysfunction in women with type 2 diabetes compared to that in an age-matched control group. In all, 50 married women with type 2 diabetes attending the outpatient endocrine clinic of Ghaem Hospital between April 2007 and March 2008 were selected. Fasting plasma glucose and glycosylated haemoglobin were measured and sexual function was assessed by questionnaire. Scores in each domain of sexual function were compared with those of 40 non-diabetic controls. Sexual function scores for the sexual drive, arousal, vaginal lubrication, orgasm and overall satisfaction domains were all lower in the diabetic women (p value diabetes and age correlated negatively with all domains of sexual function. There was no significant relationship between sexual function and body mass index (BMI), glycaemic control, education or employment status. Diabetes significantly impairs the sexual performance of diabetic women. Determinants of sexual function include age and duration of diabetes.

  1. Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy.

    NARCIS (Netherlands)

    Adhien, P.; Dijk, L. van; Vegter, M. de; Westein, M.; Nijpels, G.; Hugtenburg, J.G.

    2013-01-01

    Background: Interventions aimed to increase adherence to drug treatment usually are not tailored to the needs of individual patients. A modular pharmacy intervention, named ‘Support for Diabetes’, was developed to improve adherence to type 2 diabetes treatment. Objective: To evaluate the

  2. A core outcome set for studies evaluating the effectiveness of prepregnancy care for women with pregestational diabetes

    NARCIS (Netherlands)

    Egan, A.M. (Aoife M.); S. Galjaard (Sander); Maresh, M.J.A. (Michael J. A.); Loeken, M.R. (Mary R.); Napoli, A. (Angela); Anastasiou, E. (Eleni); Noctor, E. (Eoin); H.W. de Valk (Harold); M.N. van Poppel (Mireille); Todd, M. (Marie); Smith, V. (Valerie); Devane, D. (Declan); F. Dunne (Fidelma)

    2017-01-01

    textabstractAims/hypothesis: The aim of this study was to develop a core outcome set (COS) for trials and other studies evaluating the effectiveness of prepregnancy care for women with pregestational (pre-existing) diabetes mellitus. Methods: A systematic literature review was completed to identify

  3. Comparative Evaluation of Several Simple Screening Tests for Risk of Neuropathic Ulcerations of Feet in Patients with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Lasca Monica

    2016-03-01

    Full Text Available Background and Aims: The aim of this study is to compare and evaluate three semi-quantitative screening methods used to predict ulceration risk in diabetic patients: 10 g Semmes-Weinstein monofilament (SW, 128-Hz tuning fork and VibraTip® device.

  4. Use of anchoring vignettes to evaluate health reporting behavior amongst adults aged 50 years and above in Africa and Asia – testing assumptions

    Directory of Open Access Journals (Sweden)

    Siddhivinayak Hirve

    2013-09-01

    Full Text Available Background: Comparing self-rating health responses across individuals and cultures is misleading due to different reporting behaviors. Anchoring vignettes is a technique that allows identifying and adjusting self-rating responses for reporting heterogeneity (RH. Objective: This article aims to test two crucial assumptions of vignette equivalence (VE and response consistency (RC that are required to be met before vignettes can be used to adjust self-rating responses for RH. Design: We used self-ratings, vignettes, and objective measures covering domains of mobility and cognition from the WHO study on global AGEing and adult health, administered to older adults aged 50 years and above from eight low- and middle-income countries in Africa and Asia. For VE, we specified a hierarchical ordered probit (HOPIT model to test for equality of perceived vignette locations. For RC, we tested for equality of thresholds that are used to rate vignettes with thresholds derived from objective measures and used to rate their own health function. Results: There was evidence of RH in self-rating responses for difficulty in mobility and cognition. Assumptions of VE and RC between countries were violated driven by age, sex, and education. However, within a country context, assumption of VE was met in some countries (mainly in Africa, except Tanzania and violated in others (mainly in Asia, except India. Conclusion: We conclude that violation of assumptions of RC and VE precluded the use of anchoring vignettes to adjust self-rated responses for RH across countries in Asia and Africa.

  5. Nonalcoholic fatty liver disease in Asia: emerging perspectives.

    Science.gov (United States)

    Seto, Wai-Kay; Yuen, Man-Fung

    2017-02-01

    As in the West, nonalcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease in Asia, with a prevalence higher than 40 % in some countries. The risk factors for NAFLD development are similar to those in Western countries, including increased body mass index, diabetes, insulin resistance, and metabolic syndrome. NAFLD in Asians is associated with different extrahepatic manifestations involving the cardiovascular, gastrointestinal, and renal systems. A considerable proportion of Asians with NAFLD are described as having "lean" NAFLD. Present in approximately 20 % of the Asian population, lean NAFLD is closely linked with insulin resistance, diabetes, and other metabolic complications, but its association with disease progression to nonalcoholic steatohepatitis and cirrhosis remains to be defined. There is emerging evidence of the interactions of NAFLD with hepatitis B virus and hepatitis C virus infection in Asia. Unlike in Western countries, NAFLD constitutes only a minority of cirrhosis and hepatocellular carcinoma cases in Asia. Possible explanations are the lower prevalence of obesity and the overwhelming problem of viral hepatitis in Asia. With aging of the obesity cohort in Asia, NAFLD-related liver complications are expected to increase.

  6. Baseline characteristics in the Bardoxolone methyl EvAluation in patients with Chronic kidney disease and type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Lambers Heerspink, Hiddo J; Chertow, Glenn M; Akizawa, Tadao

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is the most important contributing cause of end-stage renal disease (ESRD) worldwide. Bardoxolone methyl, a nuclear factor-erythroid-2-related factor 2 activator, augments estimated glomerular filtration. The Bardoxolone methyl EvAluation in patients with Chronic k...... kidney disease and type 2 diabetes mellitus: the Occurrence of renal eveNts (BEACON) trial was designed to establish whether bardoxolone methyl slows or prevents progression to ESRD. Herein, we describe baseline characteristics of the BEACON population....

  7. Evaluation of antihypertensive therapy in diabetic hypertensive patients: impact of ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Shraim NY

    2009-03-01

    Full Text Available Macrovascular complications are common in diabetic hypertensive patients. Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication. Objective: To evaluate utilization patterns of antihypertensive agents and blood pressure (BP control among diabetic hypertensive patients with and without ischemic heart disease (IHD. Methods: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007. Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without IHD. Blood pressure control (equal or lower 130/80 mmHg was compared for patients receiving no therapy, monotherapy, or combination therapy and separately among patients with and without IHD. Results: 255 patients were included in the study; their mean age was 64.4 (SD=11.4 years. Sixty one (23.9% of the included patients was on target BP. Over 60% of the total patients were receiving angiotensin-converting enzyme inhibitors (ACEI/ angiotensin receptor blocker (ARB, followed by diuretics (40.8%, calcium channel blockers (25.1% and beta-blockers (12.5%. The majority (> 55% of patients were either on mono or no drug therapy. More than 55% of patients with controlled BP were using ACE-I. More than half (50.8% of the patients with controlled BP were on combination therapy while 42.3% of patients with uncontrolled BP were on combination therapy (p=0.24. More patient in the IHD achieved target BP than those in non-IHD group (p=0.019. Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups. Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines. Areas of improvement include

  8. Evaluation of wound healing properties of bioactive aqueous fraction from Moringa oleifera Lam on experimentally induced diabetic animal model.

    Science.gov (United States)

    Muhammad, Abubakar Amali; Arulselvan, Palanisamy; Cheah, Pike See; Abas, Farida; Fakurazi, Sharida

    2016-01-01

    Diabetic foot ulcer is a serious complication of diabetes, which affects a significant percentage (15%) of diabetics and up to 15%-24% of those affected may require amputation. Therefore, the economic burden of diabetic foot ulcers is enormous and is associated with high cost of treatment and prolongs hospitalization. The present study was conducted to evaluate antibacterial and in vivo wound healing activities of an aqueous fraction of Moringa oleifera on a diabetic condition. Antibacterial activity testing was carried out using agar well and tube dilution techniques. The in vivo study was conducted using six groups of animals that comprise of one normal and diabetic control group each, three treatment groups of 0.5%, 1%, and 2% w/w aqueous fraction, and a positive control group (1% w/w silver sulfadiazine). Rats were induced with diabetes using a combination of streptozotocin 65 and 150 mg/kg nicotinamide daily for 2 days, and excision wounds were created and treated with various doses (0.5%, 1%, and 2% w/w aqueous fraction) daily for 21 days. Biophysical, histological, and biochemical parameters were investigated. The results of the study revealed that aqueous fraction possessed antibacterial activity through inhibition of growth of Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli organisms. The topical application of aqueous fraction revealed enhancement of wound healing under sustained hyperglycemic condition for the duration of the experiment. This enhancement was achieved through decreased wound size, improved wound contraction, and tissue regeneration, as well as downregulation of inflammatory mediators, such as tumor necrosis factor-α, interleukin-1β, interleukin-6, inducible nitric oxide synthase, and cyclooxygenase-2, and upregulation of an angiogenic marker vascular endothelial growth factor in wound tissue treated with various doses of aqueous fraction of M. oleifera. The findings suggest that aqueous fraction of M. oleifera

  9. Action for Health in Diabetes (Look AHEAD) trial: baseline evaluation of selected nutrients and food group intake.

    Science.gov (United States)

    Vitolins, Mara Z; Anderson, Andrea M; Delahanty, Linda; Raynor, Hollie; Miller, Gary D; Mobley, Connie; Reeves, Rebecca; Yamamoto, Monica; Champagne, Catherine; Wing, Rena R; Mayer-Davis, Elizabeth

    2009-08-01

    Little has been reported regarding food and nutrient intake in individuals diagnosed with type 2 diabetes, and most reports have been based on findings in select groups or individuals who self-reported having diabetes. To describe the baseline food and nutrient intake of the Look AHEAD (Action for Health in Diabetes) trial participants, compare participant intake to national guidelines, and describe demographic and health characteristics associated with food group consumption. The Look AHEAD trial is evaluating the effects of a lifestyle intervention (calorie control and increased physical activity for weight loss) compared with diabetes support and education on long-term cardiovascular and other health outcomes. Participants are 45 to 75 years old, overweight or obese (body mass index [BMI] > or = 25), and have type 2 diabetes. In this cross-sectional analysis, baseline food consumption was assessed by food frequency questionnaire from 2,757 participants between September 2000 and December 2003. Descriptive statistics were used to summarize intake by demographic characteristics. Kruskal-Wallis tests assessed univariate effects of characteristics on consumption. Multiple linear regression models assessed factors predictive of intake. Least square estimates were based on final models, and logistic regression determined factors predictive of recommended intake. Ninety-three percent of the participants exceeded the recommended percentage of calories from fat, 85% exceeded the saturated fat recommendation, and 92% consumed too much sodium. Also, fewer than half met the minimum recommended servings of fruit, vegetables, dairy, and grains. These participants with pre-existing diabetes did not meet recommended food and nutrition guidelines. These overweight adults diagnosed with diabetes are exceeding recommended intake of fat, saturated fats, and sodium, which may contribute to increasing their risk of cardiovascular disease and other chronic diseases.

  10. Comparative evaluation of the influence of diabetic retinopathy progression factors on indices of lipid metabolism in metabolic syndrome

    Directory of Open Access Journals (Sweden)

    L.Yu. Pуlуpenko

    2017-11-01

    Full Text Available Background. The search and study of new risk factors for the development and progression of diabetic retinopathy (DRP and their modifying influence on the components of metabolic syndrome in type 2 diabetes mellitus (T2DM remain relevant. The purpose was to conduct a comparative evaluation of the impact of certain DRP development factors on indices of lipid metabolism in metabolic syndrome. Materials and methods. The research was carried out in 64 patients (95 eyes with T2DM, metabolic syndrome and DRP (males and females, average age 61.55 ± 2.37 years, average duration of diabetes 11.23 ± 2.11 years, average level of HbA1c 9.89 ± 0.78 %, average body mass index 34.55 ± 3.75 kg/m2, who were divided into 3 groups depending on the stage of DRP. Results. Results had showed that the following factors have modifying influence on the level of total cholesterol in the blood of patients with T2DM and DRP: age of patients (under 60 years, duration of diabetes (less than 10 years, decompensation of carbohydrates metabolism — for the 3rd stage of DRP, features of therapy for T2DM (oral hypoglycemic drugs — for the 2nd stage of DRP; on the level of low-density lipoprotein cholesterol: younger age of patients, decompensation of diabetes — for the 3rd stage of DRP, features of hypoglycemic therapy (insulin therapy, shorter duration of diabetes — for the 2nd stage of DRP; on the level of triglycerides: age of patients (under 60 years, duration of diabetes (less than 10 years and insulin therapy — for the 1st and 3rd stages of DRP. Conclusions. It is concluded that features of hypoglycemic therapy can be a new modifying factor for the risk of DRP progression.

  11. Renal evaluation in patients with type 2 diabetes mellitus and its association with diastolic blood pressure

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    Fokine D. Anna

    2016-04-01

    Full Text Available Background: HbA1c is correlated with the estimated glomerular filtration rate (eGFR and diastolic blood pressure (DBP. Our main objective was to evaluate the trend of biochemical and clinical variables, in relation to the eGFR in patients with type 2 diabetes mellitus (T2DM.Methods: This was a retrospective, longitudinal, and descriptive study, including patients with T2DM, who were cared for from January 2014 until December 2014, at the Clínica de Diabetes, Hospital Regional “Gral. Ignacio Zaragoza", ISSSTE, Mexico City, Mexico. eGFR was calculated using three formulas: the chronic kidney disease – epidemiology collaboration (CKD-EPI, Cockcroft-Gault, and modification of diet in renal disease (MDRD, during two periods of observation, 3 and 6 months. The results were compared by Student t tests or Wilcoxon-Mann-Whitney test depending on the variable distribution. Pearson correlation was employed to determine the relation between the eGFR determined with each formula and the analyzed variables.Results: The mean age was 56.5±11.3 years in the group of 3 months’ follow-up (n=110 and 57.1±13.8 years in the group of 6 months’ follow-up (n=47. In both groups, the formula with the lowest percentages of cases of CKD was CKD-EPI and the difference of this formula had a basal and final significant positive correlation with the DBP.Conclusion: The CKD-EPI formula showed the lowest percentages of cases of CKD in a short follow-up period, and its difference is consistently associated with the DBP, confirming the importance of controlling the later to mitigate the evolution to CKD.

  12. Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian.

    Science.gov (United States)

    Baek, Young Jin; Oh, Na Gyeong; Sohn, Cheong-Min; Woo, Mi-Hye; Lee, Seung Min; Ju, Dal Lae; Seo, Jung-Sook

    2017-04-01

    This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. 'Nutrition intervention' was 4.5 ± 0.5 for task importance, 'nutrition assessment' was 4.0 ± 0.7 for performance, and 'nutrition diagnosis' was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were 'checking basic information,' 'checking medical history and therapy plan,' 'decision of nutritional needs,' 'supply of foods and nutrients,' and 'education of nutrition and self-management.' The tasks with high importance but low performance were 'derivation of nutrition diagnosis,' 'planning of nutrition intervention,' 'monitoring of nutrition intervention process.' The tasks of both high importance and high difficulty were 'derivation of nutrition diagnosis,' 'planning of nutrition intervention,' 'supply of foods and nutrients,' 'education of nutrition and self-management,' and 'monitoring of nutrition intervention process.' The tasks of both high performance and high difficulty were 'documentation of nutrition assessment,' 'supply of foods and nutrients,' and 'education of nutrition and self-management.'

  13. Evaluation of insulin use and value for money in type 2 diabetes in the United kingdom.

    Science.gov (United States)

    Gordon, Jason; Evans, Marc; McEwan, Phil; Bain, Steve; Vora, Jiten

    2013-06-01

    It is unclear as to whether human or long-acting analog insulins represent the most efficient use of health and non-healthcare resources in the management of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the value for money relationship associated with the use of these insulins in the UK setting. A literature search was performed for studies reporting expenditure associated with the use of human and analog insulins. Data from this review informed a budget impact assessment model. Costs were converted to a common currency and results are reported in 2011 British pounds sterling (GBP) values. Annual diabetes-related medication expenditure and patients total expenditure associated with the management of T2DM were estimated to be £397 million and £3,901 million, respectively. Substitution of human insulin for analog insulins was associated with a drug acquisition cost saving of between £5 million and £23 million each year. Overall, though, total expenditure increased significantly with increased use of human insulin by £34 million to £136 million each year depending on the degree of substitution. On the face of it, analog insulins are more expensive, prompting questions about potential cost savings to health services in the UK from direct substitution to the less expensive human preparation. The current analysis illustrates that the increased use of human insulin and decreased use of analog insulin would, however, increase the overall net societal cost of managing insulin-treated patients with T2DM. Governments and decision makers should consider that total healthcare expenditure would not necessarily fall when decisions are based solely on the use of cheaper products.

  14. Hepatitis B risks and immunisation coverage amongst Australians travelling to southeast Asia and east Asia.

    Science.gov (United States)

    Leggat, Peter A; Zwar, Nicholas A; Hudson, Bernard J

    2009-11-01

    Southeast Asia and East Asia are regarded as highly endemic regions for hepatitis B virus (HBV) and include many popular destinations for Australian travellers. The objectives of this survey were to evaluate the extent of pre-travel health advice, the prevalence of behaviours with HBV infection risks and the prevalence of HBV vaccination amongst Australian travellers to Southeast Asia and East Asia. In 2004, a telephone survey was conducted amongst Australians, who had travelled overseas to Southeast Asia and East Asia in the past three years for three nights or more. Three hundred and nine travellers aged 14 years and over completed the interview, including 138 males (45%) and 171 females (55%). Respondents travelled for leisure (64%), business (20%), and visiting friends and relatives (VFR) (16%). The most common destinations were Indonesia (34%), Thailand (32%), and China (27%). About half of the travellers (54%) sought vaccination specific health advice before travel of which about half (56%) had sought this advice more than six weeks before travel. Just over one quarter of travellers reported receiving HBV vaccination (28%) of whom most (70%) were vaccinated at least three weeks before travel. About half of the travellers (49%) had participated in at least one activity with HBV risk during their last overseas trip. Of those travellers aged 18 years and over who either had no HBV vaccination or who were unsure, about half (49%) had participated in at least one activity with HBV risk during their last overseas trip. Australian travellers to Southeast Asia and East Asia commonly undertake activities with a risk of exposure to HBV. Hepatitis B vaccination coverage amongst this group remains low. It is important that travellers to this region seek travel health advice from a qualified source, which will include a risk assessment for hepatitis B vaccination.

  15. A dual enzymatic-biosensor for simultaneous determination of glucose and cholesterol in serum and peritoneal macrophages of diabetic mice: evaluation of the diabetes-accelerated atherosclerosis risk.

    Science.gov (United States)

    Huang, Qilin; An, Yarui; Tang, Linlin; Jiang, Xiaoli; Chen, Hua; Bi, Wenji; Wang, Zhongchuan; Zhang, Wen

    2011-11-30

    In this paper, a novel dual enzymatic-biosensor is described for simultaneous determination of glucose and cholesterol in serum and peritoneal macrophages (PMs) of diabetic mice to evaluate the risk of diabetes-accelerated atherosclerosis. The biosensor was constructed by a three-step method. First, a poly-thionine (PTH) film was assembled on the surface of glassy carbon electrode by cyclic voltammetric electropolymerization of thionine, which serves as an electron transfer mediator (ETM). Second, gold nanoparticles (GNPs) were covered on the surface of PTH facilitating the electron transfer between glucose oxidase (GOx), cholesterol oxidase (ChOx) and electrode. Finally, the enzymes, GOx, cholesterol esterase (ChE), and ChOx, were covalently attached to the PTH layer through a chitosan (CH) linker. The PTH coupled with GNPs provides good selectivity, high sensitivity and little crosstalk for the dual enzymatic-biosensor. The developed biosensor had good electrocatalytic activity toward the oxidations of glucose and cholesterol, exhibiting a linear range from 0.008 mM to 6.0 mM for glucose with a detection limit of 2.0 μM, and a linear range from 0.002 mM to 1.0 mM for cholesterol with a detection limit of 0.6 μM. The results of the diabetic mice demonstrated that the cholesterol level did not change obviously with the increase of glucose level in serum, while the cholesterol level was induced with the increase of the glucose level in PMs. Previous studies have shown that the large accumulation of cholesterol in macrophage could lead to macrophage foam cell formation, which is the hallmark of early atherosclerosis. This study provides useful further evidences for the development of diabetes-accelerated atherosclerosis. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Development and psychometric evaluation of a new instrument to assess nutritional perceptions and behaviors of diabetic men.

    Science.gov (United States)

    Zamani-Alavijeh, Fereshteh; Araban, Marzieh; Mohammadi, Vida; Goodarzi, Fataneh

    2017-07-03

    It is obvious that unhealthy nutritional behaviors have caused the increasing incidence of diabetes. This study aimed to design the Measure of Nutritional Perceptions and Behaviors in diabetic men and to evaluate its psychometric properties. A questionnaire was developed within 7 factors. Three methods of face validity, content validity, and construct validity were employed to ensure the validity of the scale. 206 men with diabetes completed the questionnaires. Internal was used to evaluate the reliability of the scale. The mean age of men was 58.26 (9.74) years. Results showed that each item in the final questionnaire was highly correlated with the total score of each dimension P<0.05. Moreover, factor analysis led to the extraction of 36 items with acceptable factor loadings in the range of 0.41 to 0.84, which could account for 51% of the total variance. The Cronbach's alpha coefficient equal to 0.83 was obtained for the whole scale. The reliability and validity of diabetic men's beliefs about healthy nutritional behaviors were desired and the overall structure of the questions was confirmed. This questionnaire can be used to identify individuals at risk for unhealthy nutritional behaviors and also to conduct and evaluate the impact of educational interventions. Copyright © 2017. Published by Elsevier Ltd.

  17. Evaluation of a policy to strengthen case management and quality of diabetes care in general practice in Denmark

    DEFF Research Database (Denmark)

    Rudkjøbing, Andreas; Vrangbaek, Karsten; Birk, Hans Okkels

    2015-01-01

    OBJECTIVES: To evaluate the utilization of a policy for strengthening general practitioner's case management and quality of care of diabetes patients in Denmark incentivized by a novel payment mode. We also want to elucidate any geographical variation or variation on the basis of practice features...... of the GP were are able to determine differences in use of the policy in relation to the practice-specific information. RESULTS: At the end of the study period (2007-2012) approximately 30% of practices have enrolled extending services to approximately 10% of the diabetes population. There is regional...... structure defined in the policy not strong enough to move the majority of GPs to change their way of delivering and financing care for patients with diabetes within a period of more than 5 years....

  18. Evaluation of atrophy of foot muscles in diabetic neuropathy -- a comparative study of nerve conduction studies and ultrasonography

    DEFF Research Database (Denmark)

    Severinsen, Kaare; Andersen, Henning

    2007-01-01

    OBJECTIVE: To evaluate the relation between the findings at nerve conduction studies and the size of small foot muscles determined by ultrasonography. METHODS: In 26 diabetic patients the size of the extensor digitorum brevis muscle (EDB) and of the muscles between the first and second metatarsal...... related to the size of the small foot muscles as determined by ultrasonography. SIGNIFICANCE: In diabetic patients motor nerve conduction studies can reliably determine the size of small foot muscles. Udgivelsesdato: 2007-Oct....... RESULTS: Seventeen patients fulfilled the criteria for diabetic neuropathy. The cross-sectional area of the EDB muscle and the thickness of the MIL muscle were 116 +/- 65 mm2 and 29.6 +/- 8.2 mm, respectively. Close relations were established between muscle size and the amplitude of the CMAP...

  19. Off-loading strategies in diabetic foot syndrome-evaluation of different devices.

    Science.gov (United States)

    Götz, Jürgen; Lange, Mario; Dullien, Silvia; Grifka, Joachim; Hertel, Gernot; Baier, Clemens; Koeck, Franz

    2017-02-01

    Diabetic foot syndrome is one of the most dreaded complications in diabetes mellitus. The purpose of this study was to assess the value of different offloading devices compared to walking in barefoot condition and in normal shoes both in healthy subjects and in patients with diabetes and neuropathy. Twenty patients with diabetes and polyneuropathy and ten healthy probands were included. Pedobarographic examination was performed in barefoot condition, with sneakers, postoperative shoes, Aircast® Diabetic Pneumatic Walker™ and VACO®diaped. In the diabetic group, a total contact cast was additionally tested. The most effective reduction of force was achieved by TCC (75%) and VACOdiaped (64.3%) with the VACO®diaped resulting in the most homogeneous distribution of forces all over the foot. A customized device like the TCC is still the most proven offloading device. However, a removable cast walker being based on vacuum pads and a cushioning sole, provides better results concerning force distribution.

  20. Evaluation of empowerment model on indicators of metabolic control in patients with type 2 diabetes, a randomized clinical trial study.

    Science.gov (United States)

    Ebrahimi, Hossein; Sadeghi, Mahdi; Amanpour, Farzaneh; Vahedi, Hamid

    2016-04-01

    Diabetes education is a major subject in achieving optimal glycemic control. Effective empowerment approach can be beneficial for improving patients' health. The aim of this study was to evaluate the effect of empowerment model on indicators of metabolic control in patients with type 2 diabetes. a randomized controlled trial of 103 patients with type 2 diabetes were randomly assigned to either the intervention (empowerment approach training) or the control group (conventional training) 2014. Empowerment approach training were performed for the experimental group for eight weeks. Data collection tool included demographic information form and indicators of metabolic control checklist. Analysis was performed by one-way analysis of variance, chi-square test, paired t-test, independent t-test and multiple linear regression. Before the intervention, two groups were homogeneous in terms of demographic variables, glycosylated hemoglobin (HbA1C), and other indicators of metabolic control. After the intervention, average HbA1C and other metabolic indicators except for LDL showed significant differences in the experimental group compared to the control group. study results indicated the positive effects of applying the empowerment model on the metabolic control indicators. Therefore, applying this model is recommended to nurses and the relevant authorities in order to improve clinical outcomes in diabetic patients. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  1. Evaluation of the Zucker diabetic fatty (ZDF rat as a model for human disease based on urinary peptidomic profiles.

    Directory of Open Access Journals (Sweden)

    Justyna Siwy

    Full Text Available Representative animal models for diabetes-associated vascular complications are extremely relevant in assessing potential therapeutic drugs. While several rodent models for type 2 diabetes (T2D are available, their relevance in recapitulating renal and cardiovascular features of diabetes in man is not entirely clear. Here we evaluate at the molecular level the similarity between Zucker diabetic fatty (ZDF rats, as a model of T2D-associated vascular complications, and human disease by urinary proteome analysis. Urine analysis of ZDF rats at early and late stages of disease compared to age- matched LEAN rats identified 180 peptides as potentially associated with diabetes complications. Overlaps with human chronic kidney disease (CKD and cardiovascular disease (CVD biomarkers were observed, corresponding to proteins marking kidney damage (eg albumin, alpha-1 antitrypsin or related to disease development (collagen. Concordance in regulation of these peptides in rats versus humans was more pronounced in the CVD compared to the CKD panels. In addition, disease-associated predicted protease activities in ZDF rats showed higher similarities to the predicted activities in human CVD. Based on urinary peptidomic analysis, the ZDF rat model displays similarity to human CVD but might not be the most appropriate model to display human CKD on a molecular level.

  2. Poverty increases type 2 diabetes incidence and inequality of care despite universal health coverage.

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    Hsu, Chih-Cheng; Lee, Cheng-Hua; Wahlqvist, Mark L; Huang, Hsiao-Ling; Chang, Hsing-Yi; Chen, Likwang; Shih, Shu-Fang; Shin, Shyi-Jang; Tsai, Wen-Chen; Chen, Ted; Huang, Chi-Ting; Cheng, Jur-Shan

    2012-11-01

    The discrepancy of diabetes incidence and care between socioeconomic statuses has seldom been studied concurrently in nations with universal health coverage. We aimed to delineate whether income disparity is associated with diabetes incidence and inequality of care under a national health insurance (NHI) program in Asia. From the Taiwan NHI database in 2000, a representative cohort aged ≥20 years and free of diabetes (n = 600,662) were followed up until 2005. We regarded individuals exempt from paying the NHI premium as being poor. Adjusted hazard ratios (HRs) were used to discover any excess risk of diabetes in the poor population. The indicators used to evaluate quality of diabetes care included the proportion of diabetic patients identified through hospitalization, visits to diabetes clinics, and completion of recommended diabetes tests. The incidence of type 2 diabetes in the poor population was 20.4 per 1,000 person-years (HR, 1.5; 95% CI, 1.3-1.7). Compared with their middle-income counterparts, the adjusted odds ratio (OR) for the poor population incidentally identified as having diabetes through hospitalization was 2.2 (P diabetes were less likely to visit any diabetes clinic (OR, 0.4; P diabetes to receive tests for glycated hemoglobin, low-density lipoprotein cholesterol, triglycerides, and retinopathy were 0.6 (0.4-0.9), 0.4 (0.2-0.7), 0.5 (0.4-0.8), and 0.4 (0.2-0.9), respectively. Poverty is associated not only with higher diabetes incidence but also with inequality of diabetes care in a northeast Asian population, despite universal health coverage.

  3. Evaluation of the Hypoglycaemic Activity of Petiveria alliacea (Guinea Hen Weed) Extracts in Normoglycaemic and Diabetic Rat Models.

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    Christie, S-L; Levy, A

    2013-11-01

    Petiveria alliacea (P alliacea) has ethno-traditional use as a hypoglycaemic agent in Jamaica and is yet to be scientifically validated as such. Therefore, extracts of aerial parts of the plant were evaluated for hypoglycaemic activity in normoglycaemic and diabetic rats. Aqueous and hexane extracts prepared from leaves of P alliacea were tested for hypoglycaemic activity. An acute administration of the extracts (200 and 400 mg/kg body weight) was evaluated in normoglycaemic rats. Additionally, the hypoglycaemic effect of sub-chronic administration was assessed in streptozotocin-induced diabetic rats. Blood glucose was recorded using a glucometer and test strips. Data were analysed using Student's t-test (p ≤ 0.05). The aqueous and hexane extracts demonstrated no significant reduction of fasting blood glucose (FBG) and no significant improvement of glucose tolerance in normal rats. The aqueous extract (400 mg/kg body weight) increased FBG from 4.75 ± 0.28 mmol/L to 5.88 ± 0.46 when compared to control (p ≤ 0.001). In diabetic rats, the hexane extract (400 mg/kg body weight) caused reduction of FBG after two weeks of treatment (p ≤ 0.010), but this was not sustained. The aqueous extract showed no reduction of FBG in diabetic rats. The aqueous extract of P alliacea demonstrated a hyperglycaemic effect in normoglycaemic rats and showed no hypoglycaemic activity in diabetic rats. The hexane extract caused no hypoglycaemic action in normal rats and failed to sustain an initial hypoglycaemic action in diabetic rats. This study presents evidence that does not support significant hypoglycaemic activity of P alliacea; this could hold significant implications for its use in ethno-traditional medicine.

  4. Asbestos in Asia.

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    Leong, Su Lyn; Zainudin, Rizka; Kazan-Allen, Laurie; Robinson, Bruce W

    2015-05-01

    Asbestos is a global killer. Despite lessons learned in the developed world on the use of asbestos and its hazardous pulmonary consequences, its use continues to increase in Asia. Although some countries such as Japan, Korea and Singapore have curtailed the use of this mineral, there are numerous countries in Asia that continue to mine, import and use this fibre, particularly China, which is one of the largest consumers in the world. Numerous factors ranging from political and economic to the lack of understanding of asbestos and the management of asbestos-related lung disease are keys to this observed trend. Awareness of these factors combined with early intervention may prevent the predicted Asian 'tsunami' of asbestos diseases. © 2015 Asian Pacific Society of Respirology.

  5. [Clinicofunctional evaluation of ischemic episodes and vascular endothelium in patients with type 2 diabetes].

    Science.gov (United States)

    Tatarchenko, I P; Pozdniakova, N V; Dudukina, E A; Morozova, O I

    2006-01-01

    The aim of the investigation was to study the significance of the functional condition of endothelium for the evaluation of ischemic episodes in patients with type 2 diabetes mellitus (DM2). Ninety-three patients (52 men; 41 women; mean age 58.3+/-4.8 years) were examined. Group 1 consisted of 47 patients with coronary heart disease (CHD) and CD2; group 2 consisted of 46 CAD patients without carbohydrate exchange disorder. Both groups were comparable by gender, age, and the main risk factors. The patients were examined using Holter monitoring, physical load test, EchoCG, reactive hyperemia test (ultrasound evaluation of the endothelium-dependent brachial artery dilation). The number of painless ischemic episodes (PIE), the total duration of ischemia, the maximum degree of ST depression prevailed in group 1 patients. Correlation analysis demonstrated a significant negative correlation between endothelial dysfunction, one the one part, and the number and duration of PIE and the time between the ischemic ST depression and pain syndrome, on the other, in group 1 patients.

  6. Acid rain in Asia

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    Bhatti, Neeloo; Streets, David G.; Foell, Wesley K.

    1992-07-01

    Acid rain has been an issue of great concern in North America and Europe during the past several decades. However, due to the passage of a number of recent regulations, most notably the Clean Air Act in the United States in 1990, there is an emerging perception that the problem in these Western nations is nearing solution. The situation in the developing world, particularly in Asia, is much bleaker. Given the policies of many Asian nations to achieve levels of development comparable with the industrialized world—which necessitate a significant expansion of energy consumption (most derived from indigenous coal reserves)—the potential for the formation of, and damage from, acid deposition in these developing countries is very high. This article delineates and assesses the emissions patterns, meteorology, physical geology, and biological and cultural resources present in various Asian nations. Based on this analysis and the risk factors to acidification, it is concluded that a number of areas in Asia are currently vulnerable to acid rain. These regions include Japan, North and South Korea, southern China, and the mountainous portions of Southeast Asia and southwestern India. Furthermore, with accelerated development (and its attendant increase in energy use and production of emissions of acid deposition precursors) in many nations of Asia, it is likely that other regions will also be affected by acidification in the near future. Based on the results of this overview, it is clear that acid deposition has significant potential to impact the Asian region. However, empirical evidence is urgently needed to confirm this and to provide early warning of increases in the magnitude and spread of acid deposition and its effects throughout this part of the world.

  7. South Asia and Lithuania

    Directory of Open Access Journals (Sweden)

    Talat-Kelpša Laimonas

    2016-12-01

    Full Text Available Interest in South Asia among Lithuanian scholars is rather low. For a long time the region has remained off the radar screen of Lithuanian foreign policy makers, who were largely focused on Lithuania’s Euro-Atlantic integration and international consolidation issues. But the situation is changing and South Asia is emerging as an increasingly important political and economic partner for Lithuania. This article attempts to outline the general characteristics of the South Asia region, its geographical and geopolitical limits, and its current key issues, in the backdrop of which Lithuania’s relations with the nations of the region are assessed. Arguably, at present Lithuania has little to offer in addressing the fundamental problems of the region, but its role in individual niches can be quite useful. Lithuanian exports of lasers and laser-related technologies to India, along with the growing number of South Asian students in Lithuanian higher education institutions, are brought in as two small but illustrative examples.

  8. Allergic conjunctivitis in Asia

    Science.gov (United States)

    2017-01-01

    Allergic conjunctivitis (AC), which may be acute or chronic, is associated with rhinitis in 30%–70% of affected individuals, hence the term allergic rhinoconjunctivitis (AR/C). Seasonal and perennial AC is generally milder than the more chronic and persistent atopic and vernal keratoconjunctivitis. Natural allergens like house dust mites (HDM), temperate and subtropical grass and tree pollen are important triggers that drive allergic inflammation in AC in the Asia-Pacific region. Climate change, environmental tobacco smoke, pollutants derived from fuel combustion, Asian dust storms originating from central/north Asia and phthalates may also exacerbate AR/C. The Allergies in Asia Pacific study and International Study of Asthma and Allergies in Childhood provide epidemiological data on regional differences in AR/C within the region. AC significantly impacts the quality of life of both children and adults, and these can be measured by validated quality of life questionnaires on AR/C. Management guidelines for AC involve a stepped approach depending on the severity of disease, similar to that for allergic rhinitis and asthma. Topical calcineurin inhibitors are effective in certain types of persistent AC, and sublingual immunotherapy is emerging as an effective treatment option in AR/C to grass pollen and HDM. Translational research predominantly from Japan and Korea involving animal models are important for the potential development of targeted pharmacotherapies for AC. PMID:28487836

  9. Evaluation of serum ferritin and some metal elements in type 2 diabetes mellitus patients: comparative cross-sectional study

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    Wolide AD

    2016-12-01

    Full Text Available Amare Desalegn Wolide,1 Belay Zawdie,2 Tilahun Alemayehu,3 Samuel Tadesse1 1Department of Medical Physiology, 2Department of Medical Biochemistry, 3Department of Human Anatomy, College of Health Sciences, Jimma University, Jimma, Ethiopia Background: The chronic hyperglycemia of diabetes has been associated with an imbalance of some trace metal elements in the blood sample of type 2 diabetes patients. Aim: To evaluate the status of serum ferritin and some selected metal elements among type 2 diabetes mellitus (T2DM patients. Methods: Facility-based comparative cross-sectional study was conducted from February 15, 2015 to October 30, 2015, at Jimma University Specialized Hospital, Ethiopia. A total of 428 type 2 diabetes and nondiabetes study subjects were recruited to the study. After overnight fasting, 10 mL of venous blood samples were taken for biochemical and trace metal element analysis. Data were entered into EpiData version 3.5.1 and exported to SPSS version 20 for Windows for analysis. Results: Serum concentration of Zn+2, Mg+2, Cr+3, ferritin, and Fe+3 in patients with type 2 diabetes was significantly lower (p<0.0001 than nondiabetes patients. In contrast, serum Cu+2 was significantly higher (p<0.0001 in type 2 diabetes patients than nondiabetics. In addition, significant differences were not seen in both groups with regard to serum Mn+2, Ca+2, and Po4−3. Waist-to-hip ratio (WHR, serum Fe+3, ferritin, and Mn+2 were significantly higher among oral hypoglycemic agent users of type 2 diabetes patients than the injectable insulin users. Serum Zn+2 had significant positive correlation with serum Mg+2 (r=0.738, Cr+3 (r=0.233, Ca+2 (r=0.238, and Po4−3 (r=0.222. In addition, serum Zn+2 had shown significant and negative correlation with body mass index (BMI, r=−0.331, WHR (r=−0.340, and fasting blood glucose (FBG, r=−0.186. Likewise, serum Mg+2 and Po4−3 are significantly and negatively correlated with BMI, WHR, and FBG. Conclusion

  10. Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy.

    Science.gov (United States)

    Adhien, Prem; van Dijk, Liset; de Vegter, Marinke; Westein, Marnix; Nijpels, Giel; Hugtenburg, Jacqueline G

    2013-12-01

    Interventions aimed to increase adherence to drug treatment usually are not tailored to the needs of individual patients. A modular pharmacy intervention, named 'Support for Diabetes', was developed to improve adherence to type 2 diabetes treatment. To evaluate the implementation of a new care intervention by using focus groups including pharmacy teams, and assess patient satisfaction. Community pharmacies in The Netherlands. The intervention comprises a structured patient interview, an intervention guide and modular interventions tailored to the underlying cause of non-adherence. Feasibility was studied in non-adherent type 2 diabetes mellitus patients, and evaluated by means of focus group interviews with pharmacists and pharmacy technicians. Topics included practicability of the patient selection procedure, patient interviews, materials developed for the intervention and general practitioner (GP) co-operation. Patients' experiences (n = 36) were assessed by means of a questionnaire. Feasibility of the intervention and patients' satisfaction. Pharmacists and pharmacy technicians considered the intervention feasible and appreciated its pro-active approach. Involvement of pharmacy technicians proved a stimulating factor. Poor co-operation with GPs and lack of time as well as financial compensation were interfering factors. Patients appreciated the intervention and reported to follow the advice of pharmacists. The 'Support for Diabetes' intervention is feasible to implement in pharmacy practice. Poor co-operation between pharmacists and GPs and lack of re-imbursement are obstructions for implementation on a wider scale. These issues should receive attention of pharmacists, policymakers and researchers.

  11. Comprehensive Evaluation of Anti-hyperglycemic Activity of Fractionated Momordica charantia Seed Extract in Alloxan-Induced Diabetic Rats

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    Shailesh Kumar Choudhary

    2012-01-01

    Full Text Available The present study evaluates anti-hyperglycemic activity of fractionated Momordica charantia (bitter gourd seed extracts. Fasting blood glucose levels were evaluated before and after administration of different fractions of the seed extract. Among the three fractions tested, fraction Mc-3 (15 mg/kg b.wt. showed the maximum anti-hyperglycemic activity and reduced blood glucose levels in experimental diabetic rats significantly. The activities of the key regulatory enzymes of glucose metabolism (hexokinase, pyruvate kinase, lactate dehydrogenase, and glucose-6-phosphate dehydrogenase were determined in Mc-3-treated diabetic animals. Once-daily administration of the fraction Mc-3 for prolonged period of 18 days to the experimental diabetic animals did not result in any nephrotoxicity or hepatotoxicity as evident from insignificant changes in biochemical parameters indicative of liver and kidney functions. Further fractionation of the fraction Mc-3 by size exclusion chromatography resulted in a fraction, designated Mc-3.2, possessing anti-hyperglycemic activity. The fraction Mc-3.2 showed the presence of a predominant protein band of ~11 kDa on SDS-PAGE. Loss in anti-hyperglycemic activity of the Mc-3.2 upon protease treatment indicates the proteinaceous nature of the anti-hyperglycemic principles. Overall, the results suggest that Momordica charantia seeds contain an effective anti-hyperglycemic protein(s which may find application in treatment of diabetes without evident toxic effects.

  12. Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis

    Science.gov (United States)

    Bus, Sicco A.; Haspels, Rob; Busch-Westbroek, Tessa E.

    2011-01-01

    OBJECTIVE Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P Footwear optimization lasted on average 53 min. CONCLUSIONS These findings suggest that in-shoe plantar pressure analysis is an effective and efficient tool to evaluate and guide footwear modifications that significantly reduce pressure in the neuropathic diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers. PMID:21610125

  13. Development and Evaluation of a Computer-Based, Self-Management Tool for People Recently Diagnosed with Type 2 Diabetes

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    Alison O. Booth

    2016-01-01

    Full Text Available Aim. The purpose of this study was to develop and evaluate a computer-based, dietary, and physical activity self-management program for people recently diagnosed with type 2 diabetes. Methods. The computer-based program was developed in conjunction with the target group and evaluated in a 12-week randomised controlled trial (RCT. Participants were randomised to the intervention (computer-program or control group (usual care. Primary outcomes were diabetes knowledge and goal setting (ADKnowl questionnaire, Diabetes Obstacles Questionnaire (DOQ measured at baseline and week 12. User feedback on the program was obtained via a questionnaire and focus groups. Results. Seventy participants completed the 12-week RCT (32 intervention, 38 control, mean age 59 (SD years. After completion there was a significant between-group difference in the “knowledge and beliefs scale” of the DOQ. Two-thirds of the intervention group rated the program as either good or very good, 92% would recommend the program to others, and 96% agreed that the information within the program was clear and easy to understand. Conclusions. The computer-program resulted in a small but statistically significant improvement in diet-related knowledge and user satisfaction was high. With some further development, this computer-based educational tool may be a useful adjunct to diabetes self-management. This trial is registered with clinicaltrials.gov NCT number NCT00877851.

  14. Developmental challenges of adolescents with type 1 diabetes: the role of eating attitudes, family support and fear of negative evaluation.

    Science.gov (United States)

    Williams, Catherine; Sharpe, Louise; Mullan, Barbara

    2014-01-01

    Young people with chronic illnesses including type 1 diabetes mellitus (T1DM) are at increased risk of developing psychological problems during adolescence. The aim of the present study was to explore whether a relationship exists between developmental challenges of adolescence (eating attitudes, family support and fear of negative evaluation) and psychopathology in adolescents with T1DM, and the nature of such a relationship. Sixty-one adolescents with T1DM completed a series of questionnaires assessing illness beliefs, eating attitudes, family support, Fear of Negative Evaluation (FNE) and psychopathology. The study was of a correlational design, and also included a seven-day diabetes management diary in order to collect blood glucose levels over this time. Results demonstrated the relevance of all three developmental challenges. In multiple regression analyses, FNE and eating attitudes independently predicted current levels of depressive symptomatology. Current levels of anxiety were predicted by FNE and family support, but not eating attitudes. The results support the relevance of all three developmental challenges of adolescence to psychopathology in young people with diabetes. These results suggest that in working with adolescents who are having difficulty coping with diabetes; it may be beneficial to focus on the developmental issues that commonly face adolescents.

  15. Determinants of adherence to diabetes treatment.

    Science.gov (United States)

    Larkin, Amy T; Hoffman, Christina; Stevens, Adrienne; Douglas, Andrew; Bloomgarden, Zachary

    2015-11-01

    Understanding and improving medication adherence is crucial in diabetes management. Adherence to a diabetes regimen can improve glucose control and limit the development of complications. The aim of the present study was to evaluate the extent to which a variety of factors influence diabetes medication adherence. A medication adherence survey was made available on WebMD, a medical information website for patients and/or consumers. Respondents were residents of the US, ≥18 years old, and diagnosed with either type 1 or type 2 diabetes mellitus (self-reported). Behavioral adherence (self-reported doses missed per week) correlated with perceived adherence (patients' self-report of their overall impression of medication adherence, ranked 0-5; P Adherent patients (very few [0%-10%] issues with adherence) were more likely to report having received information from their physician. Mostly adherent patients (few [11%-26%] issues with adherence) were less likely to obtain information from their physician, but reported more medication self-titration. Somewhat non-adherent patients (some [27%-46%] adherence issues) reported more "self-consciousness factors" and hypoglycemia. Non-adherent patients (many [47%-88%] adherence issues) were more likely to report worries about medication side effects. Receiving information from a healthcare provider is associated with greater diabetes medication adherence, suggesting the importance of clinicians making time to provide patient education. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  16. Diabetes Induced Changes in Podocyte Morphology and Gene Expression Evaluated Using GFP Transgenic Podocytes.

    Science.gov (United States)

    Xu, Jianxiang; Zheng, Shirong; Kralik, Patricia M; Krishnan, Laxminarayanan; Huang, Hui; Hoying, James B; Cai, Lu; Carlson, Edward C; Tan, Yi; Epstein, Paul N

    2016-01-01

    The effect of diabetes in vivo has not been examined on isolated podocytes. To achieve this, GFP was expressed constitutively in podocytes of PGFP transgenic mice which were bred to OVE mice to produce diabetic OVE-GFP mice. Viewing GFP fluorescence, foot processes of OVE-GFP podocytes were visually and measurably effaced, which did not occur with less severe STZ diabetes. Over 300,000 podocytes were purified from each PGFP mouse but only 49,000 podocytes per diabetic OVE-GFP mouse. The low yield from OVE-GFP mice appeared to be due to more fragile state of most OVE-GFP diabetic podocytes which did not survive the isolation process. Diabetic podocytes that were isolated had high levels of the lipid peroxidation product 4-HNE and they were more sensitive to death due to oxidative stress. Gene array analysis of OVE-GFP podocytes showed strong diabetes induction of genes involved in inflammation. Four CXC chemokines were induced at least 3-fold and the chemokine CXCL1 was shown for the first time to be specifically induced in podocytes by OVE, dbdb and STZ diabetes.

  17. Evaluation of antidiabetic potential of oyster mushroom (Pleurotus ostreatus) in alloxan-induced diabetic mice.

    Science.gov (United States)

    Ravi, Bindhu; Renitta, R Emilin; Prabha, M Lakshmi; Issac, Reya; Naidu, Shanti

    2013-02-01

    To study the antidiabetic activity of Pleurotus ostreatus in normal and alloxan-induced diabetic mice. Ethanolic extract of fruiting bodies of P. ostreatus was tested for their antidiabetic activity. BALB/C mice (25-30 g) were divided into four groups of six animals each normal control mice, diabetic control mice, diabetic mice posttreated with standard drug glibenclamide and diabetic mice treated with P. ostreatus ethanolic extract. Blood glucose level, biochemical parameters such as serum total cholesterol, LDL, HDL, VLDL, triglyceride creatinine, urea, and Serum glutamate oxaloacetate transaminase and Serum glutamate pyruvate transaminase were studied in alloxan-induced diabetic mice after 15 days of treatment. Animals treated with the ethanolic extract of P. ostreatus showed a significant decrease in serum glucose level (p ostreatus extract reduced serum cholesterol, triglyceride and LDL-cholesterol. The serum HDL cholesterol was significantly increased in posttreated groups. The serum creatinine, urea levels were significantly reduced in posttreated group, whereas the decrease in the body weight was arrested by administration of P. ostreatus extract to the animals. The consumption of P. ostreatus produced a significant hypoglycemic effect in diabetic mice and it is capable of improving hyperlipidemia and the impaired kidney functions in alloxan-induced diabetic mice. Thus, indicating that the ethanolic extract of P. ostreatus could be added in the list of medicinal preparations beneficial in diabetes mellitus.

  18. A Training and Support Group for Elderly Diabetics: Description and Evaluation.

    Science.gov (United States)

    Robison, Floyd F.

    1993-01-01

    Conducted 12-week diabetes support-training group for older adults having difficulty managing their diabetes because of poor dietary compliance. Results revealed that group participants (n=12 women) successfully improved their compliance to diet plans and lowered their peak blood glucose levels. (Author/NB)

  19. Comparative evaluation of torasemide and furosemide on rats with streptozotocin-induced diabetic nephropathy.

    Science.gov (United States)

    Arumugam, Somasundaram; Sreedhar, Remya; Miyashita, Shizuka; Karuppagounder, Vengadeshprabhu; Thandavarayan, Rajarajan A; Giridharan, Vijayasree V; Pitchaimani, Vigneshwaran; Afrin, Rejina; Harima, Meilei; Suzuki, Kenji; Watanabe, Kenichi

    2014-08-01

    Nephropathy is one of the complications of diabetes mellitus in human and experimental animals. There are various pathological renal remodeling processes leading to diabetic nephropathy because of the chronic hyperglycemia during diabetes mellitus. Various reports suggest the involvement of oxidative stress, inflammation and fibrosis during this progression. As antihypertensive drugs are reported to provide renoprotection in various animal models and clinical studies, we have carried out this study to identify the effect of torasemide, a loop diuretic, against streptozotocin-induced diabetic nephropathy and compare with furosemide. Here we have performed the measurement of blood and urine parameters and renal protein expression levels for measuring the disease severity in streptozotocin-induced diabetic rats treated torasemide or furosemide and compared with the vehicle treated rats. Furosemide treatment significantly increased the urinary protein excretion when compared with the normal rats. Torasemide treatment has reduced the expression of mineralocorticoid receptor and oxidative stress marker p67phox levels with improved mRNA levels of heme oxygenase-1 in the kidneys. In addition, torasemide treated diabetic rats showed significantly reduced expression of renal fibrosis related proteins when compared with the vehicle treated diabetic rats. Although furosemide treatment has produced improvement, its effects are comparably less than that of torasemide. Thus with the present results, we can suggest that torasemide treatment can improve the diabetic kidney disease in this rat model and which is superior to furosemide against renal fibrotic remodeling. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Field of Dreams Program Evaluation: Empowering the Latino Population in Type2 Diabetes Self-Management

    Science.gov (United States)

    Urteaga, Edie

    2011-01-01

    Adult onset, type2 diabetes affects Latino families at a higher rate than other ethnicities and negatively impacting their quality of life, ability to financially succeed, and ultimately impacting our overall economy. Multiple resources are available in the country to help people learn how to prevent, control, and manage diabetes. However, the…

  1. Implementation and evaluation of a low health literacy and culturally sensitive diabetes education program.

    Science.gov (United States)

    Swavely, Deborah; Vorderstrasse, Allison; Maldonado, Edgardo; Eid, Sherrine; Etchason, Jeff

    2014-01-01

    Low health literacy is more prevalent in persons with limited education, members of ethnic minorities, and those who speak English as a second language, and is associated with multiple adverse diabetes-related health outcomes. This study examined the effectiveness of a low health literacy and culturally sensitive diabetes education program for economically and socially disadvantaged adult patients with type 2 diabetes. A pre-post prospective study design was used to examine outcomes over 12 months. Outcome measures included diabetes knowledge, self-efficacy, and self-care, measured using reliable and valid survey tools, and A1C. Over this period of time 277 patients were enrolled in the program, with 106 participants completing survey data. At the completion of the program patients had significant improvements in diabetes knowledge (p education program designed to be culturally sensitive and meet the needs of individuals with low health literacy improves short-term outcomes. © 2013 National Association for Healthcare Quality.

  2. Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2

    NARCIS (Netherlands)

    Hofsteenge, G.H.; Chin A Paw, M.J.M.; Weijs, P.J.M.; van Tulder, M.W.; Delemarre-van de Waal, H.A.

    2008-01-01

    Background. In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated. Methods. Go4it is a

  3. Insulin therapy does not interfere with venous endothelial function evaluation in patients with type 2 diabetes mellitus

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    Antônio Marcos Vargas da Silva

    2010-01-01

    Full Text Available INTRODUCTION: Endothelium-dependent dilation is improved in insulin-treated diabetic patients, but this effect is probably due to improved glycemic control. The objective of the present study was to compare endothelium-dependent dilation in patients with well-controlled type 2 diabetes who are or are not using insulin as part of their therapy. METHODS: We studied 27 patients with type 2 diabetes (11 women, 60.3 years ± 6 years, with HbA1c < 7% and no nephropathy, including 16 patients treated with anti-diabetic agents (No-Ins, 8 women and 11 patients treated with insulin alone or in combination with anti-diabetic agents (Ins, 3 women. Endothelial function was evaluated by the dorsal hand vein technique, which measures changes in vein diameter in response to phenylephrine, acetylcholine (endothelium-dependent vasodilation and sodium nitroprusside (endothelium-independent vasodilation. RESULTS: Age, systolic blood pressure (No-Ins: 129.4 mmHg ± 11.8 mmHg, Ins: 134.8 mmHg ± 12.0 mmHg; P= 0.257, HbA1c, lipids and urinary albumin excretion rate [No-Ins: 9 mg/24 h (0-14.1 mg/24 h vs. Ins: 10.6 mg/24 h (7.5-14.4 mg/24 h, P=0.398] were similar between groups. There was no difference between endothelium-dependent vasodilation of the No-Ins group (59.3% ± 26.5% vs. the Ins group (54.0% ± 16.3%; P=0.526. Endothelium-independent vasodilation was also similar between the No-Ins (113.7% ± 35.3% and Ins groups (111.9% ± 28.5%; P=0.888. CONCLUSIONS: Subcutaneous insulin therapy does not interfere with venous endothelial function in type 2 diabetes when glycemic and blood pressure control are stable.

  4. Evaluation of the Effect of Hydroalcoholic Extract of Citrullus colocynthis in Normoglycemic and Streptozocine (STZ Induced Diabetic Male Rats

    Directory of Open Access Journals (Sweden)

    MR Nikbakht

    2006-07-01

    Full Text Available Introduction & Objective: Adverse side effects of chemical drugs for treatment of diabetes persuaded the using of medical plants. Citrullus colocynthis is a plant which has been used traditionally for treatment of diabetes. The purpose of this study was to evaluate the effect of hydroalcholic extract of Citrullus colocynthis fruit on normoglycemic and streptozocine induced diabetic rats. Materials & Methods: 45 male Wistar rats weighing, 250-350 gr, have been selected and randomly divided in seven groups. Group1 without any drugs usage, group 2 that received normal saline (IV and distilled water (oral, group 3 received only streptozocine (IV, group 4 received only the extract of Citrullus colocynthis (1000 mg/kg, groups 5, 6 and 7 received 500, 1000 and 1500 mg/kg of Citrullus colocynthis extract after injection of STZ and induction of diabetes. Diabetes was induced by intravenous injection (45 mg/kg of STZ. Blood sampling was provided directly from animal heart and blood sugar was measured. The collected data were analyzed by SPSS software using students t-test and ANOVA. Results: Mean of normal blood sugar in control group was 156.5±15.7 mg/dl which defined as normal blood sugar. Streptozocine significantly increased blood sugar (p<0.05. The Citrullus colocynthis extract with 500 mg/kg dosage has not significantly reduced the blood sugar but is dosage of 1000 and 1500 mg/kg significantly decreased the blood sugar in a dose-dependent mode (p<0.05. Results also showed that the extract in dosage of 1000 mg/kg did not have a significant effect on normoglycemic animals. Conclusion: Results of this study indicate that the extract of Citrullus colocynthis fruit dose-dependently reduced the blood glucose level in streptozocine-induced diabetic rats but did not have significant effect on normal blood sugar.

  5. EVALUATION OF A BREAKFAST AS SCREENING TEST FOR THE DETECTION OF GESTATIONAL DIABETES

    Directory of Open Access Journals (Sweden)

    L. Eslamian Z. Ramezani

    2008-04-01

    Full Text Available A standard breakfast was evaluated as a screening test (BT for gestational diabetes in a case-control study. Blood sugar (BS was measured 1 hour after a breakfast that had 50gr simple sugar and was designed based on women preferences. In the same women glucose challenge test (GCT, 50gr 1hour glucose screening test was performed one week later in randomized sequential. Cutoff values for both tests was 130 mg/dl. For both or one positive test GTT (100gr-oral glucose tolerance test was performed. Sensitivity and specificity; optimal cutoff and concordance of both tests with GTT were calculated by X2, receiver operating characteristic (ROC curve and kappa test. 41 women (29.3% had positive GCT and 28 women (20% had positive BT. 12 women (8.57% had positive GTT. For BT and GCT, a sensitivity of 83.3% and 91.7% and specificity of 85.9% and 76.6% with cutoff level ≥ 130 mg/dl at 60 minute were found respectively. Optimal cutoff for BT and GCT were 130 mg/dl and 135 mg/dl respectively. Concordance of GTT with GCT and BT was 0.429 and 0.432, respectively. Standard breakfast can be used as an alternative method for assessing carbohydrate intolerance in pregnancy with same physiological response, better compliance and low cost.

  6. Evaluation of non-HDL-c and total cholesterol: HDL-c ratio as cumulative marker of cardiovascular risk in diabetes mellitus.

    Science.gov (United States)

    Aryal, M; Poudel, A; Satyal, B; Gyawali, P; Pokharel, B R; Raut, B K; Adhikari, R K; Koju, R

    2010-01-01

    Cardiovascular disease (CVD), is the primary cause of morbidity and mortality in patients with diabetes and have approximately--two to four times higher CVD rate than adult without diabetes. Low density lipoprotein cholesterol (LDL-C) is primarily used as the marker of cardiovascular risk in diabetes despite its several limitations. Although several newer markers of CVD are emerging, no marker has been established in Nepal. The study was designed to evaluate the non-high-density-lipoprotein- cholesterol(Non-HDL-C) and Total Cholesterol to High density lipoprotein cholesterol (TC:HDL-C ratio) as CVD risk marker in diabetes mellitus. The study was conducted in the Department of Biochemistry, Kathmandu University School of Medical Sciences. The study comprised of 76 diabetic subjects and 60 non-diabetic subjects. The anthropometric and biochemical parameters were measured. The Non-HDL-C and TC:HDL-C ratio were also calculated employing their respective formula. Body mass index (BMI), waist circumference (WC), blood pressure and lipid parameters were significantly different between diabetic subjects and non-diabetic subjects. There was increased non-HDL-C and TC:HDL-C ratio in subjects with diabetes mellitus. Furthermore, statistically significant correlations of non-HDL-C and TC:HDL-C ratio were obtained with BMI, WC, total cholesterol, HDL-C and LDL-C in diabetic subjects. The present study observation revealed that the Non-HDL-C and TC: HDL-C strongly correlate with established independent risk factors such as obesity(WC), elevated blood pressure, HDL-C and LDL-C in diabetes. Thus, the evaluation of Non-HDL-C and TC: HDL-C ratio can be used as the simple, cost-effective and cumulative marker of cardiovascular risk in diabetes mellitus.

  7. Evaluating an Indigenous health curriculum for diabetes prevention: engaging the community through talking circles and knowledge translation of results.

    Science.gov (United States)

    Khayyat Kholghi, Maedeh; Bartlett, Gillian; Phillips, Morgan; Salsberg, Jon; McComber, Alex M; Macaulay, Ann C

    2017-07-24

    Kahnawà:ke is a Kanien'kehá:ka (Mohawk) community in Quebec, Canada. In 1997, the community-controlled Kateri Memorial Hospital Centre in partnership with the Kahnawake Education Center, and the Kahnawake Schools Diabetes Prevention Project (KSDPP) developed an elementary school diabetes prevention health education program, aimed to increase knowledge of Type 2 diabetes, healthy eating and active lifestyles. Long-term goals for KSDPP community and school interventions are to decrease obesity and diabetes. To evaluate the Kateri Memorial Hospital Centre Health Education Program for Diabetes Prevention (HEP) and use key principles of knowledge translation to promote understanding of results to upgrade HEP content and improve delivery. A KSDPP community-based participatory research team used mixed methods for evaluation, combining a cross-sectional survey for 23 teachers with interviews of two elementary school principals and three culturally appropriate Indigenous talking circles with HEP authors, teachers and parents. Questionnaire results were presented as descriptive statistics. The thematic textual analysis identified emerging themes from talking circles and interviews. Facilitators of HEP delivery were an acknowledgement of its importance; appreciation of prepared lesson plans for teachers; and KSDPP's strong community presence. Barriers included reduced administrative support and instructional time due to competing academic demands; the need for increased Kanien'kehá:ka cultural content; and outdated resource materials. Recommendations included increasing teacher training, Kanien'kehá:ka cultural content and administrative support. Community researchers undertook detailed knowledge translation activities of facilitators, barriers and recommendations with hospital and education centre administrators and Kahnawà:ke community to maximize uptake of findings before external dissemination of results.

  8. Evaluating diabetes mobile applications for health literate designs and functionality, 2014.

    Science.gov (United States)

    Caburnay, Charlene A; Graff, Kaitlin; Harris, Jenine K; McQueen, Amy; Smith, Madeleine; Fairchild, Maggie; Kreuter, Matthew W

    2015-05-07

    The expansion of mobile health technologies, particularly for diabetes-related applications (apps), grew exponentially in the past decade. This study sought to examine the extent to which current mobile apps for diabetes have health literate features recommended by participants in an Institute of Medicine Roundtable and compare the health literate features by app cost (free or not). We used diabetes-related keywords to identify diabetes-related apps for iOS devices. A random sample of 110 apps (24% of total number of apps identified) was selected for coding. The coding scheme was adapted from the discussion paper produced by participants in the Institute of Medicine Roundtable. Most diabetes apps in this sample addressed diabetes management and therapeutics, and paid apps were more likely than free apps to use plain language strategies, to label links clearly, and to have at least 1 feature (a "back" button) that helps with the organization. Paid apps were more likely than free apps to use strategies that should be more useful and engaging for people with low health literacy. Future work can investigate ways to make free diabetes mobile apps more user-friendly and accessible.

  9. Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian

    Science.gov (United States)

    2017-01-01

    This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. ‘Nutrition intervention’ was 4.5 ± 0.5 for task importance, ‘nutrition assessment’ was 4.0 ± 0.7 for performance, and ‘nutrition diagnosis’ was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were ‘checking basic information,’ ‘checking medical history and therapy plan,’ ‘decision of nutritional needs,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ The tasks with high importance but low performance were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘monitoring of nutrition intervention process.’ The tasks of both high importance and high difficulty were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘supply of foods and nutrients,’ ‘education of nutrition and self-management,’ and ‘monitoring of nutrition intervention process.’ The tasks of both high performance and high difficulty were ‘documentation of nutrition assessment,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ PMID:28503506

  10. Resolution of ketoacidosis in children with new onset diabetes: Evaluation of various definitions.

    Science.gov (United States)

    von Oettingen, Julia E; Rhodes, Erinn T; Wolfsdorf, Joseph I

    2017-10-28

    Data are sparse concerning use of serum electrolyte parameters as compared to venous blood gas (VBG) measurements to monitor acid-base status during treatment of diabetic ketoacidosis (DKA). We explored the utility of various parameters to define DKA resolution by investigating the relationship of venous pH (vpH), anion gap (AG), serum bicarbonate (HCO3), and glucose concentration during management of DKA in children with new onset diabetes mellitus (NODM). We included all patients with NODM presenting with DKA to Boston Children's Hospital from 10/1/07-7/1/13. DKA was defined as serum glucose ≥ 200 mg/dL (11.1 mmol/L) and vpHvpH≥7.30 and AG≤18 mmol/L. We used Cox regression to determine time to DKA resolution, and logistic regression to evaluate different serum HCO3 cut-off values as predictors of DKA resolution. 263 patients (133F, mean age 9.9±4.4 years, 74% White) were included. DKA was mild in 134 (51%), moderate in 75 (28%) and severe in 54 (20%). In mild DKA, AG closed after normalization of vpH; in moderate and severe DKA, AG closed before normalization of vpH. HCO3>15mmol/L correlated with vpH≥7.30, and had 76% sensitivity and 85% specificity to predict DKA resolution. Median times to DKA resolution were similar using two different definitions: vpH and AG (8.4h [IQR 6.3-11.9]) vs. HCO3>15 mmol/L (7.9 h [IQR 5.0-11.8]), p=.42. During management of pediatric DKA, HCO3 > 15 mmol/L reliably predicts resolution of DKA. In low-resource settings where VBG is unavailable, electrolyte parameters alone may be used to determine DKA resolution. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Gondwana to Asia: Preface

    Science.gov (United States)

    Kwon, Sanghoon; Kim, Sung Won; Santosh, M.

    2014-12-01

    The Korean Peninsula, China, Japan, India, Sri Lanka, and Timor, among other regions, preserve important clues for the tectonic evolution of present-day Asia derived from the break-up of Mesozoic supercontinent Pangea. Evidence for the formation, evolution, and destruction of Earth's first coherent supercontinent Columbia during Paleoproterozoic, followed by the Neoproterozoic Rodinia and late Neoproterozoic-Cambrian Gondwana supercontinents are also recorded in many of these regions. The debates surrounding some of these aspects and the state-of-the-art knowledge from these terranes were the focal themes of discussion during the "2013 Annual Convention of the International Association for Gondwana Research (IAGR) and the 10th Gondwana to Asia International Conference" held at the Korea Institute of Geoscience and Mineral Resources (KIGAM), Korea during September 30th to October 2nd 2013. The conference was attended by more than 200 delegates representing 11 countries. The discussion continued at the "International conference on Continental Dynamics" held in Xian, China during April 2014. This special issue of Journal of Asian Earth Sciences, assembling 24 research papers is an outcome of the deliberations under various sessions of the above conferences. In assembling this special issue, we attempt to provide evidence-driven discussions on the construction and destruction of Precambrian and Paleozoic supercontinents preserved in present-day Asian continents. We also address a variety of themes including magmatic, metamorphic and metallogenic processes, as well as issues related to natural environment. We hope that the papers assembled in this special issue offer new insights into some of the key issues surrounding the geological, geophysical and geodynamic milieu in Asia, and a better understanding of analogous processes in other parts of the world.

  12. Supply Chain Dynamics in Asia

    OpenAIRE

    Ruth Banomyong

    2009-01-01

    Supply chain management in Asia is a relatively novel topic but a key challenge for all Asian based manufacturers and traders when trying to integrate into the "global market". The purpose of the paper is to describe key supply chain issues faced in Asia. These issues are related to supply chain security that forces Asian firms to comply with numerous requirements as well as the importance of a properly managed supply chain in enhancing firms' competitiveness. The critical role played by Asia...

  13. Mortality in Asia.

    Science.gov (United States)

    1981-01-01

    Although the general trend in mortality between 1950 and 1975 in South and East Asia has been downward, there is considerable country-to-country variation in the rate of decline. In countries where combined economic, social, and political circumstances resulted in controlling the disease spectrum (e.g., China, Malaysia, Sri Lanka), mortality levels declined to those seen in low-mortality countries. In most of the large countries of the region however, mortality declined at a slower rate, even slowing down considerably in the 1970's while the death rates remained high (e.g., India, Bangladesh, Thailand, Philippines); this slowing down of mortality level is attributed essentially to the poverty-stricken masses of society which were not able to take advantage of social, technological, and health-promoting behavioral changes conducive to mortality decline. Infant mortality levels, although declining since 1950, followed the same dismal pattern of the general mortality level. The rate varies from less than 10/1000 live births (Japan) to more than 140/1000 (Bangladesh, Laos, Nepal). Generally, rural areas exhibited higher infant mortality than urban areas. The level of child mortality declines with increases in the mother's educational level in Bangladesh, India, Indonesia, Sri Lanka, and Thailand. The largest decline in child mortality occurs when at least 1 parent has secondary education. The premature retardation of mortality decline is caused by several factors: economic development, nutrition and food supply, provision and adequacy of health services, and demographic trends. The outlook for the year 2000 for most of Asia's countries will depend heavily on significant population increases. In most countries, particularly in South Asia, population is expected to increase by 75%, much of it in rural areas and among poorer socioeconomic groups. In view of this, Asia's health planners and policymakers will have to develop health policies which will strike a balance

  14. Teaching Modern Southeast Asia

    Directory of Open Access Journals (Sweden)

    Thomas Williamson

    2009-04-01

    Full Text Available Teaching about Southeast Asia to undergraduates at an American liberal arts college presents several challenges. At my institution, it is the only course on the region in the curriculum; thus no preparation, and no follow-up. I have therefore struggled with the approach that I should take–pulled between a wish for students to gain an empirical understanding of Southeast Asian life, and a desire to have them learn the concepts and theories of critical inquiry. Obviously I am still learning how to successfully accomplish such an ambitious undertaking.

  15. Evaluation of method performance for oxidative stress biomarkers in urine and biological variations in urine of patients with type 2 diabetes mellitus and diabetic nephropathy.

    Science.gov (United States)

    Kurutas, Ergul Belge; Gumusalan, Yakup; Cetinkaya, Ali; Dogan, Ekrem

    2015-01-01

    Oxidative stress biomarkers such as superoxide dismutase (CuZnSOD), catalase (CAT) and malondialdehyde (MDA) play an important role in the pathogenesis or progression of numerous diseases. Data regarding the biological variation and analytical quality specifications (imprecision, bias and total error) for judging the acceptability of method performance for oxidative stress biomarkers in urine are conspicuously lacking in the literature. Such data are important in setting analytical quality specifications, assessing the utility of population reference intervals (index of individuality) and assessing the significance of changes in serial results from an individual (reference change value; RCV). 20 patients with type 2 diabetes mellitus (T2DM), 20 patients with diabetic nephropathy (DN) and 14 healthy individuals as control were involved in this study. Timed first morning urine samples were taken from patients and healthy groups on the zero, 1st, 3rd, 5th, 7th, 15th and 30th days. Index of individuality and reference change value were calculated from within-subject and between-subject variations. Methods of oxidative stress biomarkers in human blood were adopted in human urine and markers were measured as spectrophotometrically. Also, analytical quality specifications for evaluation of the method performance were established for oxidative stress biomarkers in urine. Within-subject variations of oxidative stress biomarkers were significantly higher in patients with DN and T2DM compared to healthy subjects. MDA showed low individuality, and within-subject variances of MDA were larger than between-subject variances in all groups. However, CAT and CuZnSOD showed strong individuality, but within-subject variances of them were smaller than between-subject variances in all groups. RCVs of all analytes in diabetic patients were relatively higher, because of high within-subject variation, resulting in a higher RCV. Also, the described methodology achieves these goals, with

  16. Evaluation of Two-Diabetes Related microRNAs Suitability as Earlier Blood Biomarkers for Detecting Prediabetes and type 2 Diabetes Mellitus.

    Science.gov (United States)

    Al-Muhtaresh, Haifa Abdullah; Al-Kafaji, Ghada

    2018-01-26

    Increased the incidence of prediabetes and type 2 diabetes (T2D) worldwide raises an urgent need to develop effective tools for early disease detection to facilitate future preventive interventions and improve patient's care. We evaluated the suitability of diabetes-related miR-375 and miR-9 as earlier biomarkers for detecting prediabetes and T2D.TaqMan-based RT-qPCR was used to quantify the expression of miRNAs in peripheral blood of 30 prediabetes patients, 30 T2D patients and 30 non-diabetic healthy controls. Compared to controls, miR-375 and miR-9 were expressed at higher levels in prediabetes patients and progressively more enriched in T2D patients. Both miRNAs were directly associated with the presence of prediabetes and T2D independently of known risk factors to T2D and miR-375 was independently associated with the development of T2D. Both miRNAs were positively correlated with the glycemic status and other T2D risk factors. The ROC analysis indicated good diagnostic abilities for miR-375 to distinguish overall patients from control and prediabetes from T2D patients. Whereas, miR-9 showed lower values and borderline significance in discriminating the subject groups. The combination of miRNAs enhanced the predictability to discriminate patients from control. These results suggest that miR-375 and miR-9 are associated with the susceptibility to developing T2D and miR-375 alone or in combination with miR-9 could serve as biomarkers for early detection of prediabetes and T2D.

  17. Evaluation of OneTouch Verio(®), a new blood glucose self-monitoring system for patients with diabetes.

    Science.gov (United States)

    Littmann, Karin; Petersen, Eva R B; Pussinen, Christel; Danielson, Kristin; Djurisic, Snezana; Eilertsen, Heidi; Garabet, Lamya; Greibe, Eva; Lauritzen, Trine; Olsen, Dorte A; Othman, Suher; Palimaru, Irina; Westerlund, Johanna

    2013-01-01

    Self-monitoring of blood glucose (SMBG) is important in diabetes management. Reliable and user-friendly instruments are essential. OneTouch Verio(®) is a new blood glucose concentration-measuring system designed to be used by patients with diabetes and healthcare professionals. The objective of the present study was to evaluate the analytical performance of the OneTouch Verio(®). The OneTouch Verio(®) was evaluated by the Scandinavian evaluation of laboratory equipment for primary healthcare (SKUP) according to a protocol based on ISO 15197 and the American Diabetes Association (ADA) quality goals. Blood samples were collected and measured on the OneTouch Verio(®) by laboratory personnel and patients with diabetes (n = 91, randomized into groups receiving personal training or mail instructions for the OneTouch Verio(®) system). Results were compared to a validated routine method, imprecision and bias were calculated. User-friendliness was evaluated with a questionnaire. Quality specifications for blood glucose concentration monitoring systems according to ISO 15197 were fulfilled. The mean coefficients of variation (CV%) of repeatability was 3.4% when tested by laboratory personnel and within the goal of imprecision suggested by ADA. Mean CV% of repeatability for patient self-monitoring was 5.0% and 5.1% in the training- and the mail group, respectively. Total error was 6.4-10.0%. The OneTouch Verio(®) showed no hematocrit interference or variation between strip lots. The OneTouch Verio(®) displayed sufficient analytical quality and satisfactory user-friendliness. It is suitable for point-of-care testing of blood glucose concentration when handled by patients and healthcare professionals.

  18. Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

    Directory of Open Access Journals (Sweden)

    Shima Ghannadi

    2016-01-01

    Full Text Available Background. Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it. Methods. This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life. Result. 117 diabetic patients on hemodialysis (42 females with mean (SD age of 68.70±9.26 years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were 59.90±11.23, 44.27±8.35, 45.06±12.87, 46.21±10.23, and 26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities. Conclusion. The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

  19. Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group

    Directory of Open Access Journals (Sweden)

    Ana Maria da Silva Sousa

    2016-06-01

    Full Text Available SUMMARY Objective: To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM through a phone contact. Method: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Results: Most patients 119/122 patients (97.5% were managing to do self glucose monitoring. Twenty-one patients (17.2% reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7% patients said they did not; the meal frequency was not reached by 23/122 (18.9% of the women, and forty-seven (38.5% of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Conclusion: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

  20. Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group.

    Science.gov (United States)

    Sousa, Ana Maria da Silva; Fiuza, Daine; Mikami, Fernanda Cristina Ferreira; Abrão, Karen Cristine; Francisco, Rossana Pulcineli Vieira; Zugaib, Marcelo

    2016-01-01

    To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

  1. Qualitative evaluation of a mobile phone and web-based collaborative care intervention for patients with type 2 diabetes.

    Science.gov (United States)

    Lyles, Courtney Rees; Harris, Lynne T; Le, Tung; Flowers, Jan; Tufano, James; Britt, Diane; Hoath, James; Hirsch, Irl B; Goldberg, Harold I; Ralston, James D

    2011-05-01

    Drawing on previous web-based diabetes management programs based on the Chronic Care Model, we expanded an intervention to include care management through mobile phones and a game console web browser. The pilot intervention enrolled eight diabetes patients from the University of Washington in Seattle into a collaborative care program: connecting them to a care provider specializing in diabetes, providing access to their full electronic medical record, allowing wireless glucose uploads and e-mail with providers, and connecting them to the program's web services through a game system. To evaluate the study, we conducted qualitative thematic analysis of semistructured interviews. Participants expressed frustrations with using the cell phones and the game system in their everyday lives, but liked the wireless system for collaborating with a provider on uploaded glucoses and receiving automatic feedback on their blood sugar trends. A majority of participants also expressed that their participation in the trial increased their health awareness. Mobile communication technologies showed promise within a web-based collaborative care program for type 2 diabetes. Future intervention design should focus on integrating easy-to-use applications within mobile technologies already familiar to patients and ensure the system allows for sufficient collaboration with a care provider.

  2. A Modified User-Oriented Heuristic Evaluation of a Mobile Health System for Diabetes Self-management Support.

    Science.gov (United States)

    Georgsson, Mattias; Staggers, Nancy; Weir, Charlene

    2016-02-01

    Mobile health platforms offer significant opportunities for improving diabetic self-care, but only if adequate usability exists. Expert evaluations such as heuristic evaluation can provide distinct usability information about systems. The purpose of this study was to complete a usability evaluation of a mobile health system for diabetes patients using a modified heuristic evaluation technique of (1) dual-domain experts (healthcare professionals, usability experts), (2) validated scenarios and user tasks related to patients' self-care, and (3) in-depth severity factor ratings. Experts identified 129 usability problems with 274 heuristic violations for the system. The categories Consistency and Standards dominated at 24.1% (n = 66), followed by Match Between System and Real World at 22.3% (n = 61). Average severity ratings across system views were 2.8 (of 4), with 9.3% (n = 12) rated as catastrophic and 53.5% (n = 69) as major. The large volume of violations with severe ratings indicated clear priorities for redesign. The modified heuristic approach allowed evaluators to identify unique and important issues, including ones related to self-management and patient safety. This article provides a template for one type of expert evaluation adding to the informaticists' toolbox when needing to conduct a fast, resource-efficient and user-oriented heuristic evaluation.

  3. Formulation of sitagliptin-loaded oral polymeric nano scaffold: process parameters evaluation and enhanced anti-diabetic performance.

    Science.gov (United States)

    Jahangir, Mohammed Asadullah; Khan, Ruqaiyah; Sarim Imam, Syed

    2017-12-09

    The aim of the study to formulate and statistically optimize sitagliptin-loaded eudragit nanoparticles (SIT-NPs) and evaluate the in-vitro pharmaceutical quality and in-vivo anti-diabetic assessment. SIT-NPs were prepared by using combination method of solvent evaporation and nano-precipitation techniques. The influence of different independent variables as eudragit RL100 concentration (%), tween 80 concentration (%) and sonication time (min) were evaluated on dependent variables like particle size (nm), drug loading (%) and in-vitro drug release (%). Further, the optimized formulation was evaluated for surface morphology, CLSM, ex-vivo permeation study and in-vivo anti-diabetic activity and stability study. The developed SIT-NPs formulations showed particle size range (135.86-193.45 nm), drug loading (6.36-8.76%) and prolonged drug release over 24 h. The prepared SIT-NPs were found to be nearly spherical with smooth surface. The comparative in-vitro release study and CLSM study results revealed that SIT-NPopt showed significantly (p anti-diabetic assessment revealed that SIT-NPopt able to reduce the blood sugar level (BSL) for a prolonged period of time. Further, the stability study data showed the formulations were found stable at both temperature and having the shelf life of 488 d. This research has shown that SIT-NPs based on experimental design offers a new and better approach to delivering SIT, thus encouraging further development of this formulation.

  4. Type 2 diabetes affects sleep quality by disrupting the respiratory function.

    Science.gov (United States)

    Colbay, Gulcan; Cetin, Mustafa; Colbay, Mehmet; Berker, Dilek; Guler, Serdar

    2015-09-01

    The effects of diabetes on the respiratory system were investigated with arterial blood gas, sleep quality index and respiratory functions tests. Fifty-three patients with type II diabetes and 41 healthy cases were included. Their biochemical data, demographic characteristics, anthropometric measurements and echocardiographic findings were collected from polyclinic records. Respiratory function tests were performed for all subjects and Pittsburgh Sleep Quality Index questionnaire was conducted. Aforementioned data were compared between these two groups. The age, body weight and body mass index were similar but oxygen pressure, oxygen saturation, forced vital capacity (FVC; %), and sleep quality were decreased in patients with diabetes. Sleep quality was correlated with the presence of diabetes and hypertension, duration of diabetes, fasting and postprandial blood glucose levels, homeostasis model of assessment-insulin resistance, Glycosylated hemoglobin levels, and FVC. Half of the diabetic patients exhibited respiratory failure during sleep. Especially diabetic patients with autonomic neuropathy, experienced a more severe and prolonged decrease in oxygen saturation. Blood gas, respiratory functions and sleep quality, which need to be evaluated as a whole, were affected in patients with diabetes. Assessment of sleep and its quality requires special attention in patients with diabetes. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  5. Evaluation of Δ9-tetrahydrocannabinol metabolites and oxidative stress in type 2 diabetic rats

    Directory of Open Access Journals (Sweden)

    Zeynep Coskun

    2016-02-01

    Full Text Available Objective(s: The object of the study is to examine the effects of Δ9-tetrahydrocannabinol (THC against oxidative stress in the blood and excretion of THC metabolites in urine of type 2 diabetic rats. Materials and Methods: The control (n=8, THC control (n=6, diabetes (n=8 and diabetes + THC (n=7 groups were created. Type 2 diabetes was induced by nicotinamide (NA, 85 mg/kg + streptozotocin (STZ, 65 mg/kg. THC was administered intraperitoneally for seven days. The glutathione (GSH level in erythrocytes and malondialdehyde (MDA level, superoxide dismutase (SOD and catalase (CAT enzyme activities in plasma were measured. THC metabolites were analyzed in urine. Results: The results showed that the erythrocyte GSH levels were significantly increased (P

  6. Evaluation of type 2 diabetes genetic risk variants in Chinese adults

    DEFF Research Database (Denmark)

    Gan, Wei; Walters, Robin G; Holmes, Michael V

    2016-01-01

    AIMS/HYPOTHESIS: Genome-wide association studies (GWAS) have discovered many risk variants for type 2 diabetes. However, estimates of the contributions of risk variants to type 2 diabetes predisposition are often based on highly selected case-control samples, and reliable estimates of population......-level effect sizes are missing, especially in non-European populations. METHODS: The individual and cumulative effects of 59 established type 2 diabetes risk loci were measured in a population-based China Kadoorie Biobank (CKB) study of 93,000 Chinese adults, including >7,100 diabetes cases. RESULTS......: Association signals were directionally consistent between CKB and the original discovery GWAS: of 56 variants passing quality control, 48 showed the same direction of effect (binomial test, p = 2.3 × 10(-8)). We observed a consistent overall trend towards lower risk variant effect sizes in CKB than in case...

  7. Evaluation of Erythrocyte and Thrombocyte Parameters in Pediatric Patients with Diabetes Mellitus

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    Seher Erdogan

    2016-09-01

    Full Text Available Aim: To analyze erythrocyte and thrombocyte parameters in patients with diabetes, diabetic ketoacidosis, and controls. Material and Method: Patients who were diagnosed as having diabetic ketoacidosis (DKA in the pediatric emergency clinic between January 2015 and January 2016 were included in group 1; patients with type 1 diabetes mellitus (DM who consulted the pediatric endocrinology outpatient clinic for routine controls were included in group 2, and control patients were in group 3. Results: A total of 108 patients comprising 36 patients with DKA, 37 patients with DM, and 35 controls were involved in the study. The mean platelet volume (MPV of the control group was significantly lower than the DKA (p= 0.001 and DM (p= 0.001 groups (p

  8. Observational study to evaluate the safety and efficacy of saroglitazar in Indian diabetic dyslipidemia patients

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    Sadanand R. Shetty

    2015-01-01

    Conclusion: Saroglitazar is a potential therapeutic option in type 2 diabetic patients with high TG levels, not controlled by statins, for comprehensive control of lipid and glycemic parameters with acceptable safety profile.

  9. Target Blood Pressure Level in Diabetes Mellitus Type 2: Evaluation of the Scientific Evidence

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    Yu.N. Sirenko

    2013-02-01

    Full Text Available The review of the scientific evidence on the control of blood pressure (BP in patients with diabetes mellitus is given. Their analysis suggests that the optimal level of blood pressure to prevent the development of cardiovascular complications in patients with diabetes mellitus is systolic blood pressure 130–135 mmHg, diastolic blood pressure — < 80 mmHg, and not < 140 mmHg, as it’s indicated in 2012 European Guidelines on cardiovascular disease prevention.

  10. Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

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    Chaudhari Monica

    2012-07-01

    Full Text Available Abstract Background About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes. Methods Data included secondary enrollment and demographic data from Washington Dental Service (WDS and Group Health Cooperative (GH, clinical data from GH, and dental-utilization data from WDS claims during 2002–2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups. Results We found that adults with diabetes had lower odds of visiting a dentist (OR = 0.74, p  0.001. Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR = 0.77, fillings (OR = 0.80 and crowns (OR = 0.84 (p 0.005 for all and higher odds of receiving periodontal maintenance (OR = 1.24, non-surgical periodontal procedures (OR = 1.30, extractions (OR = 1.38 and removable prosthetics (OR = 1.36 (p  Conclusions Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.

  11. An evaluation of the International Diabetes Federation definition of metabolic syndrome in Chinese patients older than 30 years and diagnosed with type 2 diabetes mellitus.

    Science.gov (United States)

    Lu, Bin; Yang, Yehong; Song, Xiaoyan; Dong, Xuehong; Zhang, Zhaoyun; Zhou, Linuo; Li, Yiming; Zhao, Naiqing; Zhu, XiXing; Hu, Renming

    2006-08-01

    The objective of the study was to determine the most accurate metabolic syndrome (MS) definition among the definitions proposed by the International Diabetes Federation (IDF), the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATPIII]), and the World Health Organization (WHO) and to evaluate the cutoff point of waist circumference using the IDF definition for optimally defining MS in the Chinese population. One thousand thirty-nine Chinese patients older than 30 years and diagnosed with type 2 diabetes mellitus were investigated by randomized cluster sampling in the Shanghai downtown, and 1008 patients were analyzed in this study. Body mass measurements, resting blood pressure, fasting blood measures, and carotid atherosclerotic measurements including common carotid artery intima-media thickness (IMT) and carotid plaque were investigated. The IDF definition was compared with the other 2 definitions, and the carotid atherosclerosis was evaluated among the patients according to these definitions. (1) The MS prevalence was 50.0%, 55.7%, and 70.0% under the IDF, ATPIII, and WHO definitions, respectively. (2) The percentage of all the participants categorized as either having or not having the MS was 69.9% (under the IDF and ATPIII definitions) and 70.2% (under the IDF and WHO definitions). (3) Common carotid artery IMT of patients with MS determined by the IDF definition was thicker than those determined by the WHO and ATPIII definitions, and the percentage of carotid plaque of patients with MS determined by the IDF definition was greater than those determined by the WHO and ATPIII definitions. (4) When the cutoff point of waist circumference in men determined by the IDF definition was modified from 90 to 85 cm, common carotid artery IMT of the emerging male patients with MS was thicker than that of the male patients with MS determined by the

  12. Factors influencing the quality of life of young patients with diabetes.

    Science.gov (United States)

    Matziou, Vasiliki; Tsoumakas, Konstantinos; Vlahioti, Efrosyni; Chrysicopoulou, Leukothea; Galanis, Petros; Petsios, Konstantinos; Perdikaris, Pantelis

    2011-03-01

    Diabetes is a significant challenge for pediatric health care professionals because it affects youths' psychoemotional functioning and, consequently, the quality of life (QOL). The aim of the present study was to evaluate the QOL in young patients with diabetes, as well as the factors affecting it. The study was conducted from April to September 2008 in 98 young patients, 11-18 years of age, who were under the supervision of Diabetological Center, General Pediatric Hospital (Athens, Greece). The Diabetes Quality of Life for Youths Questionnaire was used to evaluate the QOL of youths with diabetes. The mean QOL score was 97.5. There was a negative correlation between the QOL and age (P = 0.02), the duration of diabetes (P = 0.05), body mass index (BMI; P = 0.04), and comorbidities (P = 0.03). In contrast, there was a positive correlation between QOL and increased metabolic control (P = 0.03), participating in sports activities (P = 0.007), and a greater number of insulin infusions (P = 0.04). The QOL of young diabetics was influenced by demographic, somatometric, and other characteristics of diabetes. Increased metabolic control, participating in sports activities, and a greater number of insulin infusions resulted in better QOL. Increased patient age, duration of diabetes, HbA1c values, BMI, and the coexistence of various health problems, as well as the use of an insulin pump, decreased QOL. © 2011 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

  13. Comparative Evaluation of Corneal Endothelium in Patients with Diabetes Undergoing Phacoemulsification.

    Science.gov (United States)

    Sahu, Pramod K; Das, Gopal K; Agrawal, Sumeet; Kumar, Sabitabh

    2017-01-01

    The purpose of this study is to determine if phacoemulsification with posterior chamber foldable intraocular lens implantation has a greater impact on the corneal endothelium of type 2 diabetic patients as compared to nondiabetic controls. This study compared the corneal endothelial status in sixty patients with diabetes with good glycemic control and sixty nondiabetic controls before and after (1 week, 1 month, 2 month, and 3 month) uneventful phacoemulsification. Central corneal endothelial cell density, percentage hexagonality, and coefficient of variation were measured using a noncontact specular microscope. Central corneal thickness was taken as a surrogate marker for endothelium functional status. Data were age and sex matched. Patients with diabetes showed significantly higher loss in endothelial cell count as compared to nondiabetic controls. Furthermore, the patients with diabetes showed a slower recovery trend in the endothelial healing response as evidenced by lower change in the coefficient of variation. Significant correlation was found between energy used and change in endothelial count as well as coefficient of variation in nondiabetics only. In spite of good glycemic control, patients with diabetes have significantly more endothelial damage in comparison to nondiabetic controls with similar nuclear grading and phaco energy used. This warrants a more careful use of phaco energy in patient with diabetes.

  14. Comparative evaluation of interappointment flare-ups in diabetic and nondiabetic patients

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    Nayantara Sen

    2017-01-01

    Full Text Available Aims: This study aims to compare the incidence of interappointment flare-up during endodontic treatment in diabetics and nondiabetics patients using calcium hydroxide and chlorhexidine gel as intracanal medicament. Materials and Methods: A total of 60 patients requiring root canal treatment were chosen. 30 known diabetic patients with fasting blood sugar (FBS = 100–120 mg/dl were in Group 1 while others non-diabetic patients with FBS ≤ 100 mg/dl were placed in Group 2. After initiation of endodontic procedures and biomechanical preparation, 15 patients were chosen randomly to place calcium hydroxide paste or chlorhexidine gel, as intracanal medicament in both groups. The pain was recorded on day 1, 2, 3, 7, and 14 posttreatment using verbal rating scale. Result: A total of 10 of 60 patients developed interappointment flare-up, of which 5 (16.6% were diabetics, and 2 (6% were nondiabetic patients. The results comparing the interappointment flare-ups between the groups were statistically nonsignificant (P - 0.2179. Conclusions: Although the incidence of interappointment flare-up in diabetic patients is approximately twice than that seen in nondiabetic patients, these results are nonsignificant. This indicates that interappointment flare-ups in diabetic patients with good glycemic control are essentially similar to healthy individual with no metabolic diseases.

  15. Evaluation of lectin pathway activity and mannan-binding lectin levels in the course of pregnancy complicated by diabetes type 1, based on the genetic background.

    Science.gov (United States)

    Pertyńska Marczewska, Magdalena; Cedzyński, Maciej; Swierzko, Anna; Szala, Agnieszka; Sobczak, Małgorzata; Cypryk, Katarzyna; Wilczyński, Jan

    2009-01-01

    There are numerous indications that either mannan-binding lectin (MBL) deficiency or its excessive activity are associated with adverse pregnancy outcomes. High MBL concentrations and corresponding MBL2 genotypes were shown to be associated with microvascular complications in type 1 diabetes. The aim of this study was to evaluate levels of MBL and MBL-dependent activity of the lectin pathway (LP) of complement in the course of pregnancy in diabetic mothers, based on genetic background. These parameters were determined in samples from healthy non-pregnant (control), diabetic non-pregnant, healthy pregnant, and pregnant diabetic women. No significant differences in median MBL levels or LP activities were found in any study group compared to the control. However, statistically significant differences in MBL levels were noted during pregnancy between the 1st and 3rd trimesters in both healthy controls and pregnant diabetics. With regard to LP values, similar trends were evident, but statistically significant results were obtained only in the healthy pregnant group. When data analysis was confined to patients carrying the A/A (wild-type) MBL2 genotype, an increase in MBL level during pregnancy (in both healthy and diabetic pregnant women) was still observed. Similarly, LP activity increased during both healthy and diabetic pregnancies, significantly so for the former. Diabetes, an autoimmune disease, is a serious complication of pregnancy. Therefore, determination of MBL status might be beneficial in identifying type 1 diabetic patients who are at increased risk of developing both vascular complications and poor pregnancy outcomes.

  16. Diabetes mellitus and liver cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population.

    Science.gov (United States)

    Tanaka, Keitaro; Tsuji, Ichiro; Tamakoshi, Akiko; Matsuo, Keitaro; Wakai, Kenji; Nagata, Chisato; Mizoue, Tetsuya; Inoue, Manami; Tsugane, Shoichiro; Sasazuki, Shizuka

    2014-10-01

    The potential associations of diabetes mellitus with malignant neoplasms including liver cancer have become a great concern from both clinical and preventive perspectives. Although sufficient evidence for a positive association between diabetes and liver cancer already exists, it would be informative to summarize up-to-date epidemiologic data in Japan. We systematically reviewed epidemiologic studies on diabetes and liver cancer among Japanese populations. Original data were obtained by searching the MEDLINE (PubMed) and Ichushi databases, complemented with manual searches. The evaluation was performed in terms of the magnitude of association in each study and the strength of evidence ('convincing', 'probable', 'possible' or 'insufficient'), together with biological plausibility. We identified 19 cohort studies, one pooled-analysis of seven cohort studies, and seven case-control studies. Of 24 relative risk estimates of liver cancer for diabetes reported in those cohort studies, 17 showed a weak to strong positive association, six revealed no association and one demonstrated a weak inverse association (summary relative risk 2.10, 95% confidence interval 1.60-2.76). Ten relative risk estimates from the case-control studies showed a weak to strong positive association (n = 9) or no association (n = 1; summary relative risk 2.32, confidence interval 1.73-3.12). Overall, the summary relative risk became 2.18 (confidence interval 1.78-2.69). Heterogeneity in relative risks was significant for the difference in categories of study population (P = 0.01), but not in study type (P = 0.39) or sex (P = 0.33). Diabetes mellitus 'probably' increases the risk of liver cancer among the Japanese population. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Accuracy of Different Mini Nutritional Assessment Reduced Forms to Evaluate the Nutritional Status of Elderly Hospitalised Diabetic Patients.

    Science.gov (United States)

    Martín, A; Ruiz, E; Sanz, A; García, J M; Gómez-Candela, C; Burgos, R; Matía, P; Ramalle-Gomera, E

    2016-04-01

    Disease-associated malnutrition (DAM) is a health problem involving all sanitary levels, especially hospitalised elderly patients. Different MNA (Mini Nutritional Assessment)-based forms have been validated in different settings, but it remains unclear if they are appropriate to evaluate the nutritional status of geriatric hospitalised patients with diabetes. The aim of this work was to analyse the accuracy of several MNA reduced forms to detect malnutrition in hospitalised elderly diabetic patients. A multicentre observational study was carried out in diabetic patients, who were over the age of 65, from 35 Spanish hospitals. Principal component analysis (PCA) selected the minimal components to elaborate the newly-proposed reduced new version of the MNA (r-MNA). Cohen's Kappa index (KI), with its 95% confidence interval (CI), was used to measure the agreement between the different reduced forms (r-MNA, MNA-SF-BMI, MNA-SF-CC, m-MNA) with the original MNA. Five hundred and ninety-one elderly diabetic patients were included in the study. ROC analysis determined the following cut-off points for the newly proposed r MNA: 0-12-15 "well-nourished". The upper cut-off point demonstrated a sensitivity of 87.7%, a specificity of 78.3% and an area under the curve of 0.93. The lower cut-off point showed a sensitivity of 95.9%, a specificity of 78.3% and an area under the curve of 0.95. The best agreement with the original MNA was observed for the MNA-SF-BMI (Κ index 80.7; 95% CI: 77.4-84) and the worst for the r-MNA (Κ index 72; 95% CI: 68.2-75.4). This study found that MNA-SF-BMI is the most accurate screening tool for determining the nutritional status of hospitalised diabetic elderly patients. This is an easy-to-use, fast screening tool with a low risk of misclassification.

  18. The evaluation of screening and early detection strategies for type 2 diabetes and impaired glucose tolerance (DETECT-2) update of the Finnish diabetes risk score for prediction of incident type 2 diabetes

    NARCIS (Netherlands)

    Alssema, M.J.; Vistisen, D.; Heijmans, M.W.; Nijpels, G.; Glumer, C.; Zimmet, P.Z.; Shaw, J.E.; Eliasson, M.; Stehouwer, C.D.A.; Tabak, A.G.; Colagiuri, S.; Borch-Johnsen, K.; Dekker, J.M.

    2011-01-01

    Aims/hypothesis: The Finnish diabetes risk questionnaire is a widely used, simple tool for identification of those at risk for drug-treated type 2 diabetes. We updated the risk questionnaire by using clinically diagnosed and screen-detected type 2 diabetes instead of drug-treated diabetes as an

  19. Implementation of a diabetes in pregnancy clinical register in a complex setting: Findings from a process evaluation.

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    Renae Kirkham

    Full Text Available Rates of diabetes in pregnancy are disproportionately higher among Aboriginal than non-Aboriginal women in Australia. Additional challenges are posed by the context of Aboriginal health including remoteness and disadvantage. A clinical register was established in 2011 to improve care coordination, and as an epidemiological and quality assurance tool. This paper presents results from a process evaluation identifying what worked well, persisting challenges and opportunities for improvement.Clinical register data were compared to the Northern Territory Midwives Data Collection. A cross-sectional survey of 113 health professionals across the region was also conducted in 2016 to assess use and value of the register; and five focus groups (49 healthcare professionals documented improvements to models of care.From January 2012 to December 2015, 1,410 women were referred to the register, 48% of whom were Aboriginal. In 2014, women on the register represented 75% of those on the Midwives Data Collection for Aboriginal women with gestational diabetes and 100% for Aboriginal women with pre-existing diabetes. Since commencement of the register, an 80% increase in reported prevalence of gestational diabetes among Aboriginal women in the Midwives Data Collection occurred (2011-2013, prior to adoption of new diagnostic criteria (2014. As most women met both diagnostic criteria (81% in 2012 and 74% in 2015 it is unlikely that the changes in criteria contributed to this increase. Over half (57% of survey respondents reported improvement in knowledge of the epidemiology of diabetes in pregnancy since establishment of the register. However, only 32% of survey respondents thought that the register improved care-coordination. The need for improved integration and awareness to increase use was also highlighted.Although the register has not been reported to improve care coordination, it has contributed to increased reported prevalence of gestational diabetes among

  20. A comparative evaluation of antioxidant enzymes and selenium in the serum of periodontitis patients with diabetes mellitus type 2.

    Science.gov (United States)

    Thomas, Biju; Ramesh, Amitha; Suresh, Sneha; Prasad, B Rajendra

    2013-04-01

    Chronic periodontitis is an inflammatory disease with an aberrant response characterized by exaggerated inflammation, involving the release of excess proteolytic enzymes and reactive oxygen species (ROS). Diabetes mellitus is a group of complex multisystem metabolic disorders characterized by a relative or absolute insufficiency of insulin secretion and or concomitant resistance to the metabolic action of insulin on target tissues. Increased production of ROS necessitates elevated requirements for the nutrients involved in antioxidant defenses: Selenium, zinc, and copper. Inflammatory states promote a decrease in the amount of systemic glutathione levels. Catalase is a central antioxidant enzyme constituting the primary defense against oxidative stress. This study has been designed to evaluate the comparison of glutathione, catalase, and selenium levels in the serum of diabetes mellitus type 2 patients and healthy individuals with and without periodontal disease. This study is a case control study. The study was designed as a case - control study comprising of 150 subjects, inclusive of both sexes and were divided into three groups of 50 patients each. Group I: 50 subjects with type 2 diabetes mellitus and chronic periodontitis. Group II: 50 subjects who are systemically healthy with the chronic periodontitis. Group III: 50 subjects who are systemically healthy and not suffering from. Serum samples were taken for estimation of glutathione, catalase, and selenium from all groups, and Subjected to biochemical analysis after which atomic absorption spectrophotometry method was used to obtain their levels in serum. ANOVA and Tukey HSD. The serum levels of glutathione in diabetic patients with periodontitis were significantly lower with a mean of 61.36 + 8.054 when compared to healthy individuals with and without periodontitis with a mean of 56.93 + 6.874 and 90.36 + 6.564 respectively (P ≤ 0.005). The serum levels of catalase were significantly lower in diabetic

  1. Evaluation of wound healing properties of bioactive aqueous fraction from Moringa oleifera Lam on experimentally induced diabetic animal model

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    Muhammad AA

    2016-05-01

    Full Text Available Abubakar Amali Muhammad,1 Palanisamy Arulselvan,1 Cheah Pike See,2 Farida Abas,3 Sharida Fakurazi1,2 1Laboratory of Vaccine and Immunotherapeutics, Institute of Bioscience, 2Unit of Anatomy, Department of Human Anatomy, Faculty of Medicine and Health Sciences, 3Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia Abstract: Diabetic foot ulcer is a serious complication of diabetes, which affects a significant percentage (15% of diabetics and up to 15%–24% of those affected may require amputation. Therefore, the economic burden of diabetic foot ulcers is enormous and is associated with high cost of treatment and prolongs hospitalization. The present study was conducted to evaluate antibacterial and in vivo wound healing activities of an aqueous fraction of Moringa oleifera on a diabetic condition. Antibacterial activity testing was carried out using agar well and tube dilution techniques. The in vivo study was conducted using six groups of animals that comprise of one normal and diabetic control group each, three treatment groups of 0.5%, 1%, and 2% w/w aqueous fraction, and a positive control group (1% w/w silver sulfadiazine. Rats were induced with diabetes using a combination of streptozotocin 65 and 150 mg/kg nicotinamide daily for 2 days, and excision wounds were created and treated with various doses (0.5%, 1%, and 2% w/w aqueous fraction daily for 21 days. Biophysical, histological, and biochemical parameters were investigated. The results of the study revealed that aqueous fraction possessed antibacterial activity through inhibition of growth of Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli organisms. The topical application of aqueous fraction revealed enhancement of wound healing under sustained hyperglycemic condition for the duration of the experiment. This enhancement was achieved through decreased wound size, improved wound contraction, and tissue

  2. Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital

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    J V Jose

    2017-01-01

    Full Text Available Aims: To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN in the nephrology department of a tertiary care hospital. Materials and Methods: A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February-July 2015. Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost. Results: Of 100 patients, 50 were above 60 years and 75 were male. Ninety-seven patients had hypertension, which was the most common comorbidity. The majority (60 patients belonged to Stage 5 DN and 59 patients were on dialysis. The mean number of drugs per patient was 7.60 ± 2.44. The total monthly cost per patient amounted to INR 24,203.27 with total direct cost of INR 21,013.90 (87% and indirect cost of INR 3189.30 (13%. The monthly cost of dialysis and pharmacotherapy per patient were INR 9060.00 (37% and INR 2535.98 (11%, respectively. Stage of DN (unstandardized coefficient, B = 7553.96, 95% confidence interval [CI] [6175.09-8932.82], P < 0.001 was a significant determinant of total cost. Number of drugs (B = 636.694, 95% CI [335.670-937.718], P < 0.001 and stage of DN (B = 852.986, 95% CI [297.043-1408.928], P = 0.003 were predictors of cost of pharmacotherapy. Conclusion: Stage of DN and number of drugs prescribed were major determinants of cost of pharmacotherapy.

  3. Evaluation of lorcaserin on progression of prediabetes to type 2 diabetes and reversion to euglycemia.

    Science.gov (United States)

    Nesto, Richard; Fain, Randi; Li, Yuhan; Shanahan, William

    2016-05-01

    Lorcaserin is a selective 5-HT2C (5-hydroxytryptamine 2C) receptor agonist indicated for weight management. Here, we assess the impact of lorcaserin on progression from prediabetes to type 2 diabetes (T2D) and on reversion from prediabetes to euglycemia. This is a post hoc analysis of pooled data from two Phase 3 studies, BLOOM and BLOSSOM (N = 6136), evaluating the impact of lorcaserin on weight and glycemic parameters over 52 weeks in the subpopulation of obese/overweight subjects with prediabetes, alternately defined by fasting plasma glucose (FPG) 100-125 mg/dl or glycated hemoglobin (HbA1c) 5.7-6.4% at baseline. At Week 52, in the subpopulation with prediabetes, nearly twice as many lorcaserin-treated subjects achieved ≥5% weight loss versus placebo (HbA1c: 55.6% vs. 27.5%, p lorcaserin-treated subjects progressed to T2D versus placebo based on HbA1c (lorcaserin 3.2%, placebo 5.0%, p = 0.032) but not FPG (lorcaserin 1.6%, placebo 2.6%, p = 0.227). A significantly greater proportion of lorcaserin-treated subjects versus placebo also reverted to euglycemia based on both HbA1c (lorcaserin 40%, placebo 29.5%, p lorcaserin 52.4%, placebo 46.5%, p = 0.047). In subjects with prediabetes, lorcaserin may contribute to weight loss and improve glycemic parameters, and thus may help with preventing progression to T2D and promoting reversion to euglycemia. www.clinicaltrials.gov identifiers are NCT00395135 (BLOOM) and NCT00603902 (BLOSSOM).

  4. Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital.

    Science.gov (United States)

    Jose, J V; Jose, M; Devi, P; Satish, R

    2017-01-01

    To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN) in the nephrology department of a tertiary care hospital. A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February-July 2015). Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost. Of 100 patients, 50 were above 60 years and 75 were male. Ninety-seven patients had hypertension, which was the most common comorbidity. The majority (60 patients) belonged to Stage 5 DN and 59 patients were on dialysis. The mean number of drugs per patient was 7.60 ± 2.44. The total monthly cost per patient amounted to INR 24,203.27 with total direct cost of INR 21,013.90 (87%) and indirect cost of INR 3189.30 (13%). The monthly cost of dialysis and pharmacotherapy per patient were INR 9060.00 (37%) and INR 2535.98 (11%), respectively. Stage of DN (unstandardized coefficient, B = 7553.96, 95% confidence interval [CI] [6175.09-8932.82], P < 0.001) was a significant determinant of total cost. Number of drugs (B = 636.694, 95% CI [335.670-937.718], P < 0.001) and stage of DN (B = 852.986, 95% CI [297.043-1408.928], P = 0.003) were predictors of cost of pharmacotherapy. Stage of DN and number of drugs prescribed were major determinants of cost of pharmacotherapy.

  5. Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison

    DEFF Research Database (Denmark)

    Meadows, K A; Abrams, C; Sandbaek, A

    2000-01-01

    linguistic adaptation using the forward-backward translation procedure, the 32-item DHP-1 was sent to 650 and 800 consecutively selected UK and Danish patients with Type 2 diabetes. Construct validity was assessed using principal axis factoring. Factor stability was assessed across language groups using...... the coefficient of congruence. Reliability was evaluated using Cronbach's alpha and multi-trait analysis, including item convergent/discriminant validity. Subscale discriminant validity was assessed through known groups with one-way ANOVA and post hoc Scheffe tests for multiple comparisons. RESULTS: Eighteen......) and disinhibited eating (DE). Factor congruence between language groups ranged from 0.98 to 0.99 and Cronbach's alpha ranged between 0.70 and 0.88. Item scaling success for both language versions was 88.9%. BA scores discriminated between treatment groups in both language groups (F = 24.24, P

  6. Evaluation of the Antihyperglycemic Effect of Minor Steviol Glycosides in Normoglycemic and Induced-Diabetic Wistar Rats.

    Science.gov (United States)

    Aranda-González, Irma; Moguel-Ordóñez, Yolanda; Chel-Guerrero, Luis; Segura-Campos, Maira; Betancur-Ancona, David

    2016-09-01

    Steviol glycosides are a family of compounds found in Stevia rebaudiana Bertoni that are responsible for sweetness capacity. The antihyperglycemic effect of the two major steviol glycosides, Rebaudioside A and Stevioside, has been studied and it has been found that despite having the same common structure, only Stevioside exerts an antihyperglycemic effect. Although other steviol derivatives are found in smaller amounts (minor steviol glycosides) in S. rebaudiana, whether or not they possess antihyperglycemic activity has not been evaluated. The aim of this study was to evaluate the antihyperglycemic effect of minor steviol glycosides in normoglycemic and diabetic (streptozotocin/nicotinamide) Wistar rats. Rats were subjected to an intraperitoneal glucose tolerance test (IPGTT) both before and after chronic treatment (28 days). After 6 h of fasting, IPGTT was conducted in pentobarbital-anesthetized rats using 1 g/kg of glucose plus 20 mg/kg of the minor glycoside (Dulcoside A, Rebaudioside B, C, D, or Steviolbioside) or control treatment (distilled water, glibenclamide, or metformin); the blood of the tip of the tail was collected at time 0, 15, 30, 60, and 120 min.; and blood glucose was measured, and its net area under the curve (AUCnet) was calculated. After 28-day chronic oral administration, IPGTT was again performed. Differences were considered significant at P diabetic Wistar rats. Considering the dose tested, it is unlikely that these glycosides have an effect on glucose in diabetic or normoglycemic humans.

  7. Development of a porcine model of type 1 diabetes by total pancreatectomy and establishment of a glucose tolerance evaluation method.

    Science.gov (United States)

    Kobayashi, Kazuya; Kobayashi, Naoya; Okitsu, Teru; Yong, Chen; Fukazawa, Takuya; Ikeda, Hideaki; Kosaka, Yoshikazu; Narushima, Michiki; Arata, Takashi; Tanaka, Noriaki

    2004-11-01

    To develop and evaluate the efficacy of diabetes-targeted cell therapies in humans, a reliable model in larger animals is highly desirable. This article reports the surgical technique of total pancreatectomy in pigs and the biochemical analysis of the characteristics of totally pancreatectomized pigs. Surgical total pancreatectomy was conducted in 23 pigs. Blood glucose, insulin, biochemistries, activity index, and intravenous glucose tolerance test (IVGTT) were examined to assess the pathophysiological profiles of diabetic pigs. A total of 14 pigs successfully underwent total pancreatectomy without requiring biliary reconstruction and were analyzed in the present study. Activity index was decreased from day 5 on and the mean survival of totally pancreatectomized pigs was 7.6 +/- 2.7 days. No endogenous insulin secretion was confirmed in these pigs. Pigs which received total pancreatectomy demonstrated significantly higher levels of ketone bodies. IVGTT performed within 4 days after total pancreatectomy showed a spontaneous decrease in blood glucose levels despite an absence of endogenous insulin secretion. IVGTT on day 5 or later showed continued hyperglycemia in pigs with total pancreatectomy. Histological examination showed atrophy of hepatocytes and decreased glycogen storage in the liver and decreased mucus production of the small intestine. This article describes a porcine model of diabetes created by total pancreatectomy and it analyzes the pathophysiological profiles in the animals. The present study has suggested that IVGTT on day 5 or later after total pancreatectomy is a reliable method to evaluate the efficacy of cell therapies.

  8. Application of an Online-Coupled Regional Climate Model, WRF-CAM5, over East Asia for Examination of Ice Nucleation Schemes: Part I. Comprehensive Model Evaluation and Trend Analysis for 2006 and 2011

    Directory of Open Access Journals (Sweden)

    Ying Chen

    2015-08-01

    Full Text Available Online-coupled climate and chemistry models are necessary to realistically represent the interactions between climate variables and chemical species and accurately simulate aerosol direct and indirect effects on cloud, precipitation, and radiation. In this Part I of a two-part paper, simulations from the Weather Research and Forecasting model coupled with the physics package of Community Atmosphere Model (WRF-CAM5 are conducted with the default heterogeneous ice nucleation parameterization over East Asia for two full years: 2006 and 2011. A comprehensive model evaluation is performed using satellite and surface observations. The model shows an overall acceptable performance for major meteorological variables at the surface and in the boundary layer, as well as column variables (e.g., precipitation, cloud fraction, precipitating water vapor, downward longwave and shortwave radiation. Moderate to large biases exist for cloud condensation nuclei over oceanic areas, cloud variables (e.g., cloud droplet number concentration, cloud liquid and ice water paths, cloud optical depth, longwave and shortwave cloud forcing. These biases indicate a need to improve the model treatments for cloud processes, especially cloud droplets and ice nucleation, as well as to reduce uncertainty in the satellite retrievals. The model simulates well the column abundances of chemical species except for column SO2 but relatively poor for surface concentrations of several species such as CO, NO2, SO2, PM2.5, and PM10. Several reasons could contribute to the underestimation of major chemical species in East Asia including underestimations of anthropogenic emissions and natural dust emissions, uncertainties in the spatial and vertical distributions of the anthropogenic emissions, as well as biases in meteorological, radiative, and cloud predictions. Despite moderate to large biases in the chemical predictions, the model performance is generally consistent with or even better

  9. Preliminary study: Evaluation of melatonin secretion in children and adolescents with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Yilmaz Kor

    2014-01-01

    Full Text Available Objective: Melatonin is an indolamine hormone, synthesized from tryptophan in the pineal gland primarily. Melatonin exerts both antioxidative and immunoregulatory roles but little is known about melatonin secretion in patients with type 1 diabetes mellitus (T1DM. The aim of this study was to measure serum melatonin levels in patients with T1DM and investigates their relationship with type 1 diabetes mellitus. Materials and Methods: Forty children and adolescents with T1DM (18 boys and 22 girls and 30 healthy control subjects (17 boys and 13 girls participated in the study. All patients followed in Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine and also control subjects had no hypertension, obesity, hyperlipidemia, anemia, and infection. Blood samples were collected during routine analysis, after overnight fasting. Serum melatonin levels were analyzed with ELISA. Results: There were no statistically significant differences related with age, sex, BMI distribution between diabetic group and control group. Mean diabetic duration was 2.89 ± 2.69 years. The variables were in the equation. Mean melatonin level in diabetic group was 6.75 ± 3.52 pg/ml and mean melatonin level in control group was 11.51 ± 4.74 pg/ml. Melatonin levels were significantly lower in diabetic group compared to controls (P < 0.01. Conclusions: Melatonin was associated with type 1 diabetes mellitus significantly. Because of the varied roles of melatonin in human metabolic rhythms, these results suggest a role of melatonin in maintaining normal rhythmicity. Melatonin may play role in preventing process of inflammation and oxidative stress.

  10. Genitourinary Complications of Diabetes Mellitus: An Overview of Pathogenesis, Evaluation, and Management.

    Science.gov (United States)

    Gandhi, Jason; Dagur, Gautam; Warren, Kelly; Smith, Noel L; Khan, Sardar A

    2017-01-01

    Diabetes mellitus is a vastly prevalent metabolic disorder with escalating global health concerns. Particularly when mismanaged, chronic micro- and macrovascular complications may highly impair physiological systems while immunodeficiency disposes us to infection. We investigate infections, localized complications, and neoplasms of the genitourinary system secondary to the chronic complications of diabetes mellitus in males and females. A comprehensive MEDLINE® search was guided using key words relevant to diabetes mellitus and the genitourinary system. Pathogen-friendly environments may implicate the sequelae of urinary tract and genital mycotic infections, potentially generating necrosis, abscess, and other inflammatory complications, which may present concomitantly with neurogenic and/or vasculogenic dysfunction to further exacerbate an existing genitourinary condition. Manifestations of the adrenal, renal, and genital organs and tissues are discussed as they relate to vascular, immunodeficient, and other hyperglycemic complications of the diabetic state. Among those, chronic kidney disease and cystopathy are the most prevailing and detrimental. Though studies have connected diabetes to either an increased risk of developing or poor prognosis of bladder, renal, prostate, endometrial, and cervical cancers, the explicit biological relationships are as of yet inconclusive. Despite the availability of precise treatments to ameliorate most presently reviewed conditions, particularly urinary tract and genital mycotic infection-related sequelae, reversing permanent vascular damage remains a great challenge. Leading a healthier lifestyle and managing diabetes mellitus with a patient-centric approach from the outset are the most putative methods for preventing critical long-term genitourinary manifestations of diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  11. Morphological changes of the peripheral nerves evaluated by high-resolution ultrasonography are associated with the severity of diabetic neuropathy, but not corneal nerve fiber pathology in patients with type 2 diabetes.

    Science.gov (United States)

    Ishibashi, Fukashi; Taniguchi, Miki; Kojima, Rie; Kawasaki, Asami; Kosaka, Aiko; Uetake, Harumi

    2015-05-01

    To evaluate the morphological changes of the median and posterior tibial nerve using high-resolution ultrasonography, and the corneal C fiber pathology by corneal confocal microscopy in type 2 diabetic patients. The cross-sectional area, hypoechoic area and maximum thickness of the nerve fascicle of both nerves were measured by high-resolution ultrasonography in 200 type 2 diabetic patients, stratified by the severity of diabetic neuropathy, and in 40 age- and sex-matched controls. These parameters were associated with corneal C fiber pathology visualized by corneal confocal microscopy, neurophysiological tests and severity of diabetic neuropathy. The cross-sectional area, hypoechoic area and maximum thickness of the nerve fascicle of both nerves in patients without diabetic neuropathy were larger than those in control subjects (P neuropathy (P neuropathy, and deteriorated only in patients with the most severe neuropathy. The association between the morphological changes of both nerves and corneal C fiber pathology was poor. The morphological changes in peripheral nerves of type 2 diabetic patients were found before the onset of neuropathy, and were closely correlated with the severity of diabetic neuropathy, but not with corneal C fiber pathology.

  12. Evaluation of lipid peroxidation activity at intravenous administration of gold nanorods in rats with simulated diabetes and transplanted liver cancer

    Science.gov (United States)

    Bucharskaya, Alla B.; Dikht, Natalia I.; Afanasyeva, Galina A.; Terentyuk, Georgy S.; Maslyakova, Galina N.; Zaraeva, Nadezhda V.; Khlebtsov, Nikolai G.; Khlebtsov, Boris N.

    2014-01-01

    In the experiment the white outbred rats with transplanted liver cancer (cholangiocarcinoma line PC-1) and simulated alloxan diabetes were treated by single intravenous injection of gold nanorods. State of lipid peroxidation was evaluated by the following parameters: the malondialdehyde, lipid hydroperoxide, the average weght molecules in the serum of animals by conventional spectrophotometric methods study using a spectrofluorometer RF-5301 PC (Shimadzu, Japan). In both experimental groups of animals the significant increasing of levels of lipid peroxidation products was noted compared with control group. After intravenous administration of nanoparticles in the group of animals with alloxan diabetes the activation of a free radical oxidation was not observed, in group with transplanted liver cancer the increasing of levels of lipid hydroperoxide, malondialdehyde was established.

  13. Evaluation of glycemic control in patients with type 2 diabetes mellitus in Chinese communities: a cross-sectional study.

    Science.gov (United States)

    Shan, Shan; Gu, Liubao; Lou, Qinglin; Ouyang, Xiaojun; Yu, Yun; Wu, Haidi; Bian, Rongwen

    2017-02-01

    This study aimed to evaluate the glycemic levels in Chinese patients with type 2 diabetes mellitus (T2DM) and to explore the factors related to the results of glycemic control. A total of 2454 T2DM patients from 11 communities were examined for glycosylated hemoglobin levels and glycemic control options. Potential factors related to the results of glycemic control were analyzed using logistic regression. Of all the patients, 55.3 % achieved the glycemic control target of HbA1c diet and exercise, insulin injection was most strongly associated with poor glycemic control (OR 6.210, 95 % CI 4.054-9.514; P diabetic durations showed poor glycemic control, which was not found in female patients. Glycemic control was not satisfactory in T2DM patients of Nanjing communities. Various factors are associated with poor results of glycemic control.

  14. Pediatric cardiology in Asia.

    Science.gov (United States)

    Vongprateep, C

    1981-01-01

    The problems of pediatric cardiology in Asia can be summarized as follows. In the countries like India, Indonesia, Malaysia, Pakistan and some other countries especially with government support like Thailand, the priority is primary health care. Except in Japan, cardiac care for children is not well supported financially. Training in pediatric cardiology is not readily available. Consequently small numbers of pediatric cardiologists, pediatric cardiac surgeons and active centres are available even in Japan. It is importannt to reduce the incidence of rheumatic fever and rheumatic heart disease by prevention of streptococcal infections and to increase the standard of living and environment. Transportation and referral system diagnosis, and treatment and follow-up is a special problem in neonatal care in relation to heart disease. Concentration of physicians, medical schools and cardiac centers in urban areas, old customs and poor understanding of people about the treatability and preventability of heart diseases in children complicate the improvement in the management of children with heart diseases.

  15. An economic evaluation for prevention of diabetes mellitus in a developing country: a modelling study.

    Science.gov (United States)

    Liu, Xiaoqian; Li, Changping; Gong, Hui; Cui, Zhuang; Fan, Linlin; Yu, Wenhua; Zhang, Cui; Ma, Jun

    2013-08-07

    The serious consequences of diabetes mellitus, and the subsequent economic burden, call for urgent preventative action in developing countries. This study explores the clinical and economic outcomes of strategies that could potentially prevent diabetes based on Chinese circumstances. It aims to provide indicators for the long-term allocation of healthcare resources for authorities in developing countries. A representative sample of Chinese adults was used to create a simulated population of 20,000 people aged 25 years and above. The hybrid decision tree Markov model was developed to compare the long-term clinical and economic outcomes of four simulated diabetes prevention strategies with a control group, where no prevention applied. These preventive strategies were the following: (i) one-off screening for undiagnosed diabetes and impaired glucose tolerance (IGT), with lifestyle interventions on diet, (ii) on exercise, (iii) on diet combined exercise (duo-intervention) respectively in those with IGT, and (iv) one-off screening alone. Independent age-specific models were simulated based on diverse incidences of diabetes, mortalities and health utilities. The reported outcomes were the following: the remaining survival years, the quality-adjusted life years (QALYs) per diabetes or IGT subjects, societal costs per simulated subject and the comparisons between preventions and control over 40 years. Sensitivity analyses were performed based on variations of all assumptions, in addition to the performance and the compliance of screening. Compared with the control group, all simulated screening programmes prolonged life expectancy at the initiation ages of 25 and 40 years, postponed the onset of diabetes and increased QALYs at every initiation age. Along with an assumption of six years intervention, prevention programmes were associated with cost-saving compared with the control group, especially in the population aged 25 years. The savings were at least US$2017 per

  16. Evaluation of the burden of type 2 diabetes mellitus in population of Puducherry, South India.

    Science.gov (United States)

    Bharati, D R; Pal, Ranabir; Rekha, R; Yamuna, T V

    2011-01-01

    To find out the prevalence of undiagnosed diabetes mellitus and the correlates among the adult population of Puducherry, South India. In this population based cross-sectional study in the rural and urban field practice area of Mahatma Gandhi Medical College and Research Institute, Puducherry, by simple random sampling 1013 adults of 30 years and above, not on anti-diabetics drugs were included. Main outcome measures were the prevalence and correlates of undiagnosed diabetes mellitus among the adult population. Pre-designed and pre-tested questionnaire was used to elicit the information on family and individual socio-demographic variables. Height, weight, waist and hip circumference, blood pressure were measured and venous blood was collected to measure fasting blood glucose and blood cholesterol. Overall, 10.3% study subjects were diagnosed as diabetic. In univariate analysis age, dilatory habit, tobacco addiction, body mass index, waist hip ratio, hypertension, and total blood cholesterol were found statistically significant. In multivariate logistic regression (LR method) analysis age, residence, education, dietary habit, tobacco addiction, body mass index, waist hip ratio and total blood cholesterol were statistically significant. In our study adults having increased age, urban residence, illiterate, non-vegetarian diet, tobacco addiction, obese and high total blood cholesterol were important correlates. Copyright © 2010 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  17. Evaluation of the corneal endothelium in patients with diabetes mellitus type I and II.

    Science.gov (United States)

    Módis, László; Szalai, Eszter; Kertész, Katalin; Kemény-Beke, Adám; Kettesy, Beáta; Berta, András

    2010-12-01

    The aim of the present study is to determine corneal physiology and endothelial morphology after proper image analysis technique in type I and II diabetic patients. The HbA1c level and the grade of retinopathy were also recorded and correlated with the endothelial parameters. 41 eyes of 21 patients with type I and 59 eyes of 30 patients with type II diabetes mellitus (mean age was 40.97 ± 15.46 and 64.36 ± 10.47 years) were examined and compared to age-matched controls. Endothelial cell density (ECD), mean cell area, coefficient of variation of cell area, central corneal thickness, intraocular pressure, and grade of retinopathy were recorded. There was a statistically significant decreased endothelial cell density in type I disease (2428 ± 219 cell/mm2) in comparison with healthy subjects (2495 ± 191 cell/mm2, P=0.02). The diabetic corneas were thicker than normal (P=0.001). The HbA1c level was inversely correlated with the ECD (r=-0.60; Pevaluated values. The present study disclosed the alteration of the corneal endothelial morphology in type I diabetes mellitus as compared to normal subjects. The results indicated that type I diabetic corneas are more susceptible to environmental changes than type II corneas.

  18. Evaluation of diabetes and cardiovascular disease print patient education materials for use with low-health literate populations.

    Science.gov (United States)

    Hill-Briggs, Felicia; Smith, Andrea S

    2008-04-01

    Populations with the lowest literacy and health literacy in the U.S. are also among those disproportionately burdened by diabetes and its complications. Yet, suitability of publicly available diabetes and cardiovascular (CVD) patient education materials for these patients is not clear. We evaluated selected American Diabetes Association (ADA) and American Heart Association (AHA) print education materials for accessibility and usability characteristics. English-language, print patient education brochures addressing lifestyle/behavioral management of diabetes and CVD were obtained from the ADA (n = 21) and the AHA (n = 19). Materials were evaluated using 32 criteria, 23 addressing literacy demand and 9 addressing behavioral activation, compiled from authoritative sources on development of low-literacy consumer health information. Of the 32 criteria identified by two or more sources, ADA materials consistently met 11 (34%) and AHA materials consistently met 8 (25%). Criteria most frequently achieved were text case, use of cues (e.g., bullets) to emphasize key points, design of graphics/illustrations, some provision of "how to" information, and positive depiction of cultural images. The least consistently achieved criteria were reading grade, word usage (e.g., scientific jargon), sentence length, font size, line length, white space, visual organization, limited scope, clear and specific (e.g., step-by-step) behavioral recommendations, and demonstration of audience relevance and cultural appropriateness. Materials consistently met few criteria for usability by patients with low literacy, limited prior medical knowledge, and/or limited resource availability. Use of available criteria and methods for increasing reach of print education materials to these underserved patient populations is indicated.

  19. Impact of migration and acculturation on prevalence of type 2 diabetes and related eye complications in Indians living in a newly urbanised society.

    Science.gov (United States)

    Zheng, Yingfeng; Lamoureux, Ecosse L; Ikram, M Kamran; Mitchell, Paul; Wang, Jie Jin; Younan, Christine; Anuar, Ainur Rahman; Tai, E-Shyong; Wong, Tien Y

    2012-01-01

    Health of migrants is a major public health challenge faced by governments and policy makers. Asian Indians are among the fastest growing migration groups across Asia and the world, but the impact of migration and acculturation on diabetes and diabetes-related eye complications among Indians living in urban Asia remains unclear. We evaluated the influence of migration and acculturation (i.e., migration status and length of residence) on the prevalence of type-2 diabetes mellitus (T2DM) and diabetes-related eye complications (diabetic retinopathy (DR) and cataract), among first-generation (defined as participant born in India with both parents born in India, n = 781) and second-generation (participants born in Singapore with both parents born in India, n = 1,112) Indian immigrants from a population-based study of Adult Indians in Singapore. Diabetes was defined as HbA1c≥6.5%, use of diabetic medication or a physician diagnosis of diabetes. Retinal and lens photographs were graded for the presence of DR and cataract. Compared to first generation immigrants, second generation immigrants had a higher age- and gender-standardized prevalence of T2DM (34.4% versus 29.0%, pprevalence of DR (31.7% versus 24.8%, pdiabetes and greater likelihood of having T2DM and diabetes-related eye complications. Second generation immigrant Indians and longer length of residence are associated with higher prevalence of diabetes and diabetes-related complications (i.e., DR and cataract) among migrant Indians living in Singapore. These data highlight potential worldwide impacts of migration patterns on the risk and burden of diabetes.

  20. Medical Vanguard Diabetes Management

    National Research Council Canada - National Science Library

    Mun, Seong K

    2004-01-01

    The Medical Vanguard Diabetes Management Project was designed to deploy an Internet based diabetes management system, MyCareTeam, into a number of existing diverse clinical environments and evaluate...

  1. Medical Vanguard Diabetes Management

    National Research Council Canada - National Science Library

    Mun, Seong K

    2006-01-01

    The Medical Vanguard Diabetes Management Project was designed to deploy an Internet based diabetes management system, MyCare Team, into a number of existing diverse clinical environments and evaluate...

  2. Diabetes mellitus is strongly associated with tuberculosis in Indonesia.

    NARCIS (Netherlands)

    Alisjahbana, B.; Crevel, R. van; Sahiratmadja, E.; Heijer, M. den; Maya, A.; Istriana, E.; Danusantoso, H.; Ottenhoff, T.H.M.; Nelwan, R.H.; Meer, J.W.M. van der

    2006-01-01

    SETTING: Diabetes mellitus is a known risk factor for tuberculosis (TB), but no studies have been reported from South-East Asia, which has a high burden of TB and a rapidly growing prevalence of diabetes. OBJECTIVE: To examine if and to what extent diabetes is associated with an increased risk of TB

  3. Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes

    Science.gov (United States)

    Peabody, John W; DeMaria, Lisa; Smith, Owen; Hoth, Angela; Dragoti, Edmond; Luck, Jeff

    2017-01-01

    : Countries of Eastern Europe and Central Asia are challenged by poor performance as measured by clinical care vignettes, but there is potential for provision of high-quality care by a sizable proportion of providers. Large-scale assessments of quality of care have been hampered by the lack of effective measurement tools that provide generalizable and reliable results across diverse economic, cultural, and social settings. The feasibility of quality measurement using CPV vignettes in these 6 countries and the ability to combine results with individual feedback could significantly enhance strategies to improve quality of care, and ultimately population health. PMID:28963174

  4. Long-term observations of black carbon mass concentrations at Fukue Island, western Japan, during 2009-2015: Evaluating bottom-up emission inventories for East Asia

    Science.gov (United States)

    Kanaya, Y.; PAN, X.; Miyakawa, T.; Komazaki, Y.; Taketani, F.; Uno, I.; Kondo, Y.

    2016-12-01

    Long-term (2009-2015) observations of atmospheric black carbon (BC) mass concentrations were performed using a continuous soot-monitoring system (COSMOS) at Fukue Island, western Japan, to provide information on wet removal rate constraints and the emission strengths of important source regions in East Asia (China and others). Here we focus on the analysis of spatio-temporal variations in the BC/CO emission ratio. For the analysis, we only used the observed ΔBC/ΔCO ratio when precipitation did not occur along the backward trajectories for 72 hours. Backward trajectory analysis was also used to classify the air mass origin areas. For individual origin areas, cases with BC concentrations in the highest 25% range, with maximum relative humidity along the trajectory over the previous three days in the lowest 25% range, and with the traveling times in the shortest 25% range were critically selected for the analysis. The observed tendencies that the average ΔBC/ΔCO ratio was higher for the air masses from south Central East China (S-CEC, 7.6 ng m-3 ppb-1) than that from North-CEC (6.4 ng m-3 ppb-1) and that the ratio was higher in winter than spring in S-CEC suggested stronger influence from domestic sector in S-CEC. The REAS2 bottom up emission inventory qualitatively captured these features; quantitatively however, the emission ratios were overestimated at least by a factor of 1.3. For Korea, the observed ΔBC/ΔCO ratio (8.4 ng m-3 ppb-1) was significantly overpredicted by REAS2 (23.2 ng m-3 ppb-1), pointing to the necessity of revising the emission database. The large discrepancy seems originating from too high BC/CO emission ratios assumed for industry and transportation sectors in emission inventory studies (e.g., 42 and 27 ng m-3 ppb-1 for REAS2). The results were similar for MEIC and CAPSS, emission inventories developed in China and Korea, respectively. On the other hand, the observed ratio for Japan (6.7 ng m-3 ppb-1) only differed slightly ( 10%) from the

  5. ELSID-Diabetes study-evaluation of a large scale implementation of disease management programmes for patients with type 2 diabetes. Rationale, design and conduct – a study protocol [ISRCTN08471887

    Directory of Open Access Journals (Sweden)

    Gensichen Jochen

    2005-10-01

    Full Text Available Background Diabetes model projects in different regions of Germany including interventions such as quality circles, patient education and documentation of medical findings have shown improvements of HbA1c levels, blood pressure and occurrence of hypoglycaemia in before-after studies (without control group. In 2002 the German Ministry of Health defined legal regulations for the introduction of nationwide disease management programs (DMP to improve the quality of care in chronically ill patients. In April 2003 the first DMP for patients with type 2 diabetes was accredited. The evaluation of the DMP is essential and has been made obligatory in Germany by the Fifth Book of Social Code. The aim of the study is to assess the effectiveness of DMP by example of type 2 diabetes in the primary care setting of two German federal states (Rheinland-Pfalz and Sachsen-Anhalt. Methods/Design The study is three-armed: a prospective cluster-randomized comparison of two interventions (DMP 1 and DMP 2 against routine care without DMP as control group. In the DMP group 1 the patients are treated according to the current situation within the German-Diabetes-DMP. The DMP group 2 represents diabetic care within ideally implemented DMP providing additional interventions (e.g. quality circles, outreach visits. According to a sample size calculation a sample size of 200 GPs (each GP including 20 patients will be required for the comparison of DMP 1 and DMP 2 considering possible drop-outs. For the comparison with routine care 4000 patients identified by diabetic tracer medication and age (> 50 years will be analyzed. Discussion This study will evaluate the effectiveness of the German Diabetes-DMP compared to a Diabetes-DMP providing additional interventions and routine care in the primary care setting of two different German federal states.

  6. Assessing the Potential Use of Eye-Tracking Triangulation for Evaluating the Usability of an Online Diabetes Exercise System.

    Science.gov (United States)

    Schaarup, Clara; Hartvigsen, Gunnar; Larsen, Lars Bo; Tan, Zheng-Hua; Årsand, Eirik; Hejlesen, Ole Kristian

    2015-01-01

    The Online Diabetes Exercise System was developed to motivate people with Type 2 diabetes to do a 25 minutes low-volume high-intensity interval training program. In a previous multi-method evaluation of the system, several usability issues were identified and corrected. Despite the thorough testing, it was unclear whether all usability problems had been identified using the multi-method evaluation. Our hypothesis was that adding the eye-tracking triangulation to the multi-method evaluation would increase the accuracy and completeness when testing the usability of the system. The study design was an Eye-tracking Triangulation; conventional eye-tracking with predefined tasks followed by The Post-Experience Eye-Tracked Protocol (PEEP). Six Areas of Interests were the basis for the PEEP-session. The eye-tracking triangulation gave objective and subjective results, which are believed to be highly relevant for designing, implementing, evaluating and optimizing systems in the field of health informatics. Future work should include testing the method on a larger and more representative group of users and apply the method on different system types.

  7. Evaluation of 75 g glucose load in non-fasting state [Diabetes in Pregnancy Study group of India (DIPSI) criteria] as a diagnostic test for gestational diabetes mellitus.

    Science.gov (United States)

    Tripathi, Reva; Verma, Divya; Gupta, Vinod Kumar; Tyagi, Shakun; Kalaivani, M; Ramji, Siddarth; Mala, Y M

    2017-02-01

    There is no consensus regarding optimal standard for diagnosis of gestational diabetes mellitus (GDM). In this study, use of 75 g glucose load in non-fasting state [Diabetes in Pregnancy Study Group of India (DIPSI) criteria] as a diagnostic test for GDM in pregnant women was compared with different oral glucose tolerance tests (OGTTs). This prospective study included 936 pregnant women, who underwent plasma glucose evaluation two hours after the challenge of 75 g glucose load irrespective of the timing of last meal (DIPSI criteria for GDM). After three days, standard 75 g OGTT was done in all women irrespective of previous plasma glucose value. Accuracy of the first result was compared to OGTT using cut-offs as per the World Health Organization (WHO) and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for the diagnosis of GDM. Of the total 936 pregnant women, 73 (7.8%) patients had plasma glucose value ≥140 mg/dl when measured two hours after glucose load. When comparing with the WHO and IADPSG criteria, the sensitivity values were 65.1 and 74.1 per cent, respectively, and the corresponding specificity values were 96.3 and 96.9 per cent, respectively. On comparing with the WHO OGTT, only 41 of the 73 (56.2%) were true positives, whereas when IADPSG criteria were used, true positives were 46 (63%). False negative cases were also present when classified by the WHO and IADPSG criteria though in lesser numbers than false positives. The positive predictive values (PPVs) for the WHO and IADPSG criteria were 56.1 and 63 per cent, respectively, and their corresponding negative predictive values were 97.7 and 97.9 per cent, respectively. Our findings showed that when 75 g glucose load in non-fasting state was used as a diagnostic test for GDM, almost one quarter of patients with GDM escaped diagnosis as sensitivity values were low. On the other hand, some GDM cases were falsely labelled as normal as this test did not account for cases

  8. Diabetic Coma

    Science.gov (United States)

    ... Overview A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously ... Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed March 31, 2015. Hyperglycemia ( ...

  9. Prevalence of Diabetes Mellitus in People Clinically Diagnosed with Periodontitis: A Systematic Review and Meta-analysis of Epidemiologic Studies.

    Science.gov (United States)

    Ziukaite, Laura; Slot, Dagmar E; Van der Weijden, Fridus A

    2017-11-10

    Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes. The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis were extracted or if possible calculated. From the 803 titles and abstracts that came out of the search, 29papers met the initial criteria. Prevalence of diabetes was 9.4% among subjects with periodontitis and 12.8%among subjects without periodontitis. Based on sub-analysis, for subjects with periodontitis, the prevalence of diabetes was 6.5%when diabetes was self-reported, compared to 17.3%when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries(17.2%,n=16647) and the lowest in studies describing populations from Europe(4.3%(n=7858). The overall odds ratio for diabetes patients to be among subjects with periodontitis as compared to those without periodontitis was 2.59(95%CI[2.12;3.15]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias. The overall prevalence and odds of having diabetes is higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Prevalence and characteristics of non-obese diabetes in Japanese men and women: the Yuport Medical Checkup Center Study.

    Science.gov (United States)

    Kashima, Saori; Inoue, Kazuo; Matsumoto, Masatoshi; Akimoto, Kimihiko

    2015-07-01

    This study examined the prevalence and characteristics of type 2 diabetes in non-obese subjects to compare their cardiometabolic markers to those without diabetes. Data were used from 17,098 men and 17,199 women from a voluntary health checkup program between 1998 and 2006 conducted in Japan. The prevalence of diabetes (fasting plasma glucose ≥ 7.0 mmol/L, hemoglobin A1c ≥ 6.5%, or known diabetes) was calculated in each subgroup of body mass index (group 1, <22; group 2, 22-25; group 3, 25-27.5; and group 4, ≥ 27.5). The effect of diabetes and obesity on risk of an abnormal level of cardiometabolic marker was evaluated with a logistic regression model. In men, the prevalence of diabetes was 9.5% in total, 6.4%, 9.4%, 11.3% and 16.2% in group 1 through 4, respectively. In women, it accounted for 4.3% in total, 2.4%, 4.5%, 8.7% and 12.3% per group, respectively. Non-obese diabetic subjects (in group 1 and 2) accounted for 60.8% and 62.0% of all the diabetic subjects in men and women, respectively. Non-obese population accounted for 71.2% and 83.6% of all men and women, respectively. Levels of cardiometabolic markers were higher in diabetic subjects than in non-diabetic subjects in each subgroup. Diabetes was associated with each abnormal level of cardiometabolic marker independent of obesity. Over 60% of the diabetic subjects in this Japanese population were not obese. Non-obese diabetes is not widely addressed and should be considered for increased public attention. The elevated levels of cardiometabolic markers may contribute to an increased risk of cardiovascular disease in non-obese diabetes. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  11. Texting for Health: An Evaluation of a Population Approach to Type 2 Diabetes Risk Reduction With a Personalized Message.

    Science.gov (United States)

    Khurshid, Anjum; Brown, Lisanne; Mukherjee, Snigdha; Abebe, Nebeyou; Kulick, David

    2015-11-01

    txt4health is an innovative, 14-week, interactive, population-based mobile health program for individuals at risk of type 2 diabetes, developed under the Beacon Community Program in the Greater New Orleans, La., area. A comprehensive social marketing campaign sought to enroll hard-to-reach, at-risk populations using a combination of mass media and face-to-face engagement in faith-based and retail environments. Little is known about the effectiveness of social marketing for mobile technology application in the general population. A systematic evaluation of the campaign identified successes and barriers to implementing a population-based mobile health program. Face-to-face engagement helped increase program enrollment after the initial launch; otherwise, enrollment leveled off over time. Results show positive trends in reaching target populations and in the use of mobile phones to record personal health information and set goals for reducing the risk of type 2 diabetes. The lessons from the txt4health campaign can help inform the development and programmatic strategies to provide a person-level intervention using a population-level approach for individuals at risk for diabetes as well as aid in chronic disease management.

  12. Evaluation of the telephone intervention in the promotion of diabetes self-care: a randomized clinical trial.

    Science.gov (United States)

    Fernandes, Bárbara Sgarbi Morgan; Reis, Ilka Afonso; Torres, Heloisa de Carvalho

    2016-08-29

    to evaluate the effectiveness of the telephone intervention for promoting self-care related to physical activity and following a diet plan in users with diabetes, compared to conventional monitoring of users over a six-month period. this was a randomized clinical trial, which included 210 users with diabetes, linked to eight Primary Health Units of Belo Horizonte, Minas Gerais. The experimental group (104 members) received six telephone interventions over the six-month monitoring; the control group (106 members) received conventional monitoring. To evaluate the self-care practices related to physical activity and following a healthy eating plan, in both groups, the self-care questionnaire was applied before the intervention and at three and six months after its start. the mean effect of self-care scores in the experimental group was 1.03 to 1.78 higher than the control group, with progressive and significant improvement (pautocuidado relacionado à atividade física e ao seguimento de um plano alimentar, em usuários com diabetes, quando comparada ao acompanhamento convencional dos usuários, durante o período de seis meses. trata-se de um ensaio clínico randomizado, no qual participaram 210 usuários com diabetes, vinculados a oito Unidades Básicas de Saúde de Belo Horizonte, Minas Gerais. O grupo-experimental (104 usuários) recebeu seis intervenções telefônicas em seis meses de acompanhamento; o grupo-controle (106 usuários) recebeu acompanhamento convencional. Para avaliar as práticas de autocuidado, relacionada à atividade física e ao seguimento do plano alimentar saudável, em ambos os grupos, aplicou-se o questionário de autocuidado antes das intervenções, três e seis meses após o seu início. o efeito médio dos escores de autocuidado no grupo-experimental a pontuação foi de 1,03 a 1,78 maior do que o grupo-controle, apresentando melhora progressiva e significativa (valor-pautocuidado em diabetes. O registro clínico obteve identificador

  13. Evaluation of the hypothalamic-pituitary-gonadal axis in eugonadal men with type 2 diabetes mellitus.

    Science.gov (United States)

    Costanzo, P R; Suárez, S M; Scaglia, H E; Zylbersztein, C; Litwak, L E; Knoblovits, P

    2014-01-01

    Men with type 2 diabetes mellitus (DM2) have lower testosterone levels and a higher prevalence of hypogonadism. It still remains unclear the mechanism by which there is a relationship between hypogonadism and DM2. The objective was to evaluate the hypothalamic-pituitary-gonadal axis at different levels in eugonadal patients with DM2. Fourteen patients with DM2 (DM2 group) and 15 subjects without DM2 (normal glucose tolerance test) as control group (CG) were included. We assessed: (i) fasting glucose, insulin, Homeostasis Model Assessment (HOMA); (ii) luteinizing hormone (LH) pulsatility through blood collections every 10 min for 4 h; (iii) gonadotropin-releasing hormone (GnRH) test: basal LH and 30, 60 and 90 min after 100 μg of i.v. GnRH; (iv) human chorionic gonadotropin (hCG) test: basal total testosterone (TT), bioavailable testosterone (BT), free testosterone (FT), estradiol (E2), bioavailable E2 (BE2) and sex hormone-binding globulin (SHBG) and 72 h post 5000 IU of i.m. hCG. There were no differences in age, body mass index and waist circumference between groups. Glucose was higher in the DM2 group vs. CG: 131.1 ± 25.5 vs. 99.1 ± 13.6 mg/dL, p = 0.0005. There were no difference in basal insulin, HOMA, TT, BT, FT, E2, BE2, SHBG and LH levels between groups. The DM2 group had lower LH pulse frequency vs. CG: 0.8 ± 0.8 vs. 1.5 ± 0.5 pulses, p = 0.009. Differences in LH pulse amplitude were not found. A negative correlation was found between the number of LH pulses and glucose, r: -0.39, p = 0.03. There were no differences in the response of LH to GnRH between groups nor in the response of sexual steroids and SHBG to hCG. Patients with DM2 showed lower hypothalamic pulse frequency without changes in the pituitary response to GnRH nor testicular response to hCG. Glucose levels negatively correlated with the number of LH pulses which suggests a negative effect of hyperglycaemia in the hypothalamic secretion of GnRH. © 2013 American

  14. Evaluation of cell proliferation and apoptosis in placentas of rats with severe diabetes

    Directory of Open Access Journals (Sweden)

    Marilza Vieira Cunha Rudge

    2012-04-01

    Full Text Available The aim of this work was to analyze the cell proliferation and apoptosis indexes on the 18th and 21st days of pregnancy of diabetic rats and to correlate with maternal glycemia and perinatal outcomes. Placentas from 20 Wistar rats were collected and divided into four experimental groups: control and diabetic of 18 and 21 days of pregnancy. The cell proliferation was analyzed using the PCNA expression and apoptosis by the TUNEL method. It was observed that PCNA and TUNEL indexes decreased from day 18 to 21 of pregnancy in the placentas of diabetic rats and these values were lower than control groups. Diabetic dams presented higher percentage of small for pregnancy age (SPA fetuses. However, there was no difference between the PCNA and TUNEL indexes in SPA and N-SPA fetuses in all the groups and these indexes were not correlated to maternal glycemic. Thus, placental cell proliferation and apoptosis did not interfere in the intrauterine growth restriction.

  15. Synthesis and biological evaluation of novel gigantol derivatives as potential agents in prevention of diabetic cataract

    Science.gov (United States)

    As a continuation of our efforts directed towards the development of natural anti-diabetic cataract agents, gigantol was isolated from Herba dendrobii and was found to inhibit both aldose reductase (AR) and inducible nitric oxide synthase (iNOS) activity, which play a significant role in the develop...

  16. A 75 g glucose In pregnancy load for diabetic an evaluation screening

    African Journals Online (AJOL)

    1989-08-19

    Aug 19, 1989 ... Polyhydramnios. An infant suspected of being large for gestational age. Department of Obstetrics and Gynaecology, R. K. Khan. Hospital, Durban. R. PATHER, M.R.C.O.G.. Accepted 14 Mar 1989. A number of screening methods for diabetes in pregnancy have been investigated. Originally O'Sullivan el al.

  17. "Evaluating Causality of Gut Microbiota in Obesity and Diabetes in Humans"

    NARCIS (Netherlands)

    Meijnikman, Abraham S.; Gerdes, Victor E.; Nieuwdorp, Max; Herrema, Hilde

    2017-01-01

    The pathophysiology of obesity and obesity-related diseases such as type 2 diabetes mellitus (T2DM) is complex and driven by many factors. One of the most recently identified factors in development of these metabolic pathologies is the gut microbiota. The introduction of affordable, high-throughput

  18. An evaluation of a self-management package for people with diabetes at risk of chronic kidney disease.

    Science.gov (United States)

    Thomas, Nicola; Bryar, Rosamund

    2013-07-01

    The overall purpose was to develop, test and evaluate an educational package to help people with diabetes self-manage their risk of developing chronic kidney disease (CKD), one of the main complications of diabetes. Management of people in primary care who have both CKD and diabetes can be controlled by strict blood pressure (BP) and blood sugar control and advice on lifestyle changes, such as smoking cessation. However, there is little evidence to support the assertion that self-management can slow the rate of kidney disease progression. A mixed-method longitudinal study. Development of the self-management package was informed by the findings of a case study in six GP Practices and also through interviews with 15 patients. Testing of the self-management package was undertaken in the same six Practices, with one additional control Practice. Patients with Type 1 or Type 2 diabetes at risk of kidney disease were included. Outcomes in patients in the participating surgeries who did receive a pack (n = 116) were compared with patients in the control group (n = 60) over 6 time points. At the end of the study (time point 6), the intervention group had a mean systolic BP of 4.1 mmHg lower and mean diastolic BP of 2.7 mmHg lower than in the control group. Self-management techniques such as understanding of, and subsequent concordance with, prescribed BP medication may contribute to a reduction in BP, which in turn will reduce cardiovascular risk. This study contributes to the evidence base for self-management of early kidney disease. Although the exact reason for reduced BP in the intervention group is unclear, the importance of practitioner understanding of kidney disease management and patient understanding of BP medication are likely to be the contributing factors.

  19. Evaluation of accuracy of ambulatory glucose profile in an outpatient setting in children with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Anjana Hulse

    2016-01-01

    Full Text Available Background: In children with type 1 diabetes, intensive diabetes management has been demonstrated to reduce long-term microvascular complications. At present, self-monitoring of blood glucose (SMBG by patients at home and glycated hemoglobin estimation every 3 months are used to monitor glycemic control in children. Recently, ambulatory glucose profile (AGP is increasingly being used to study the glycemic patterns in adults. However, accuracy and reliability of AGP in children have not been evaluated yet. Objectives: To assess the accuracy of AGP data in children with type 1 diabetes mellitus when compared with laboratory random blood sugar (RBS levels, capillary blood glucose (CBG measured by glucometer in the hospital, and SMBG monitored at home. Methods: Paired RBS, CBG, and AGP data were analyzed for 51 patients who wore AGP sensors for 2 weeks. Simultaneous venous and CBG samples were collected on day 1 and day 14. SMBG at home was checked and recorded by the patients for optimizing insulin doses. Accuracy measures (mean absolute deviation, mean absolute relative difference (MARD, and coefficient of linear regression of AGP on RBS, CBG, and home-monitored SMBG were calculated. Results: Seventy paired RBS, CBG, and AGP data and 362 paired home-monitored SMBG and AGP data were available. The MARD was 9.56% for AGP over RBS and 15.07% for AGP over CBG. The linear regression coefficient of AGP over RBS was 0.93 and that of AGP over CBG was 0.89 (P 200 mg/dl. Conclusion: In this study, AGP data significantly correlate with RBS and CBG data in children with type 1 diabetes. However, a large number of samples in a research setting would help to document reproducibility of our results.

  20. A Trial-Based Economic Evaluation Comparing Spinal Cord Stimulation With Best Medical Treatment in Painful Diabetic Peripheral Neuropathy.

    Science.gov (United States)

    Slangen, Rachel; Faber, Catharina G; Schaper, Nicolaas C; Joosten, Elbert A; van Dongen, Robert T; Kessels, Alfons G; van Kleef, Maarten; Dirksen, Carmen D

    2017-04-01

    The objective was to perform an economic evaluation comparing spinal cord stimulation (SCS) in combination with best medical treatment (BMT) with BMT in painful diabetic peripheral neuropathy patients. Alongside a prospective 2-center randomized controlled trial, involving 36 painful diabetic peripheral neuropathy patients with severe lower limb pain not responding to conventional therapy, an economic evaluation was performed. Incremental cost-effectiveness ratios were based on: 1) societal costs and quality-adjusted life years (QALYs), and 2) direct health care costs and the number of successfully treated patients, respectively, both with a time horizon of 12 months. Bootstrap and secondary analyses were performed to address uncertainty. Total societal cost amounted to €26,539.18 versus €5,313.45 per patient in the SCS and BMT group, respectively. QALYs were .58 versus .36 and the number of successfully treated patients was 55% versus 7% for the SCS and BMT group, respectively. This resulted in incremental cost-effectiveness ratios of €94,159.56 per QALY and €34,518.85 per successfully treated patient, respectively. Bootstrap analyses showed that the probability of SCS being cost-effective ranges from 0 to 46% with willingness to pay threshold values ranging between €20,000 and €80,000 for a QALY. Secondary analyses showed that cost-effectiveness of SCS became more favorable after correcting for baseline cost imbalance between the 2 groups, extending the depreciation period of SCS material to 4 years, and extrapolation of the data up to 4 years. Although SCS was considerably more effective compared with BMT, the substantial initial investment that is required resulted in SCS not being cost-effective in the short term. Cost-effectiveness results were sensitive to baseline cost imbalances between the groups and the depreciation period of the SCS material. Painful diabetic peripheral neuropathy is a common complication of diabetes mellitus and the

  1. Decision Support for Diabetes in Scotland: Implementation and Evaluation of a Clinical Decision Support System.

    Science.gov (United States)

    Conway, Nicholas; Adamson, Karen A; Cunningham, Scott G; Emslie Smith, Alistair; Nyberg, Peter; Smith, Blair H; Wales, Ann; Wake, Deborah J

    2017-09-01

    Automated clinical decision support systems (CDSS) are associated with improvements in health care delivery to those with long-term conditions, including diabetes. A CDSS was introduced to two Scottish regions (combined diabetes population ~30 000) via a national diabetes electronic health record. This study aims to describe users' reactions to the CDSS and to quantify impact on clinical processes and outcomes over two improvement cycles: December 2013 to February 2014 and August 2014 to November 2014. Feedback was sought via patient questionnaires, health care professional (HCP) focus groups, and questionnaires. Multivariable regression was used to analyze HCP SCI-Diabetes usage (with respect to CDSS message presence/absence) and case-control comparison of clinical processes/outcomes. Cases were patients whose HCP received a CDSS messages during the study period. Closely matched controls were selected from regions outside the study, following similar clinical practice (without CDSS). Clinical process measures were screening rates for diabetes-related complications. Clinical outcomes included HbA1c at 1 year. The CDSS had no adverse impact on consultations. HCPs were generally positive toward CDSS and used it within normal clinical workflow. CDSS messages were generated for 5692 cases, matched to 10 667 controls. Following clinic, the probability of patients being appropriately screened for complications more than doubled for most measures. Mean HbA1c improved in cases and controls but more so in cases (-2.3 mmol/mol [-0.2%] versus -1.1 [-0.1%], P = .003). The CDSS was well received; associated with improved efficiencies in working practices; and large improvements in guideline adherence. These evidence-based, early interventions can significantly reduce costly and devastating complications.

  2. [Evaluation of the quality of care for diabetic patients in Latin America].

    Science.gov (United States)

    Gagliardino, J J; de la Hera, M; Siri, F

    2001-11-01

    To make a preliminary diagnosis of the quality of care that individuals with diabetes mellitus (DM) received in participating centers of the QUALIDIAB network in Latin America and the Caribbean, and to assess the potential usefulness of this information as well as the importance of expanding the QUALIDIAB network. A total of 13,513 patient records from the QUALIDIAB network were analyzed, from public and private health care entities and from the Social Security systems of Argentina, Brazil, Chile, Colombia, Paraguay, and Uruguay. The study utilized: 1) quality-of-care indicators based on international reference values, 2) patient information on clinical, biochemical, and therapeutic parameters and on the rate of use of diagnostic and therapeutic materials, 3) a computer database program, and 4) a software program for statistical analysis. Among the patients studied, about half of them had suffered from diabetes for 5 years or less; this was true both for persons with type 1 diabetes (DM1) and for those with type 2 diabetes (DM2). Of the persons with DM1, 24% of them had a blood glucose level of 7.7 mmol/L was 41% among those with DM1 and 57% among those with DM2. The frequencies of association between DM2 and other cardiovascular risk factors were: overweight/obesity, 59%; hypertension, 60%; total cholesterol > 5.5 mmol/L, 53%; high-density lipoprotein cholesterol 1.7 mmol/L, 45%; and smoking, 13%. Of the people with DM1, 20% of them had a body mass index Latin America and the Caribbean, and that QUALIDIAB could help do this. Expanding the QUALIDIAB network will help to more accurately diagnose the quality of that care in the Americas, and it will facilitate interventions aimed at optimizing the care. This, in turn, will improve the quality of life of persons who suffer from diabetes as well as diminish the socioeconomic costs of the disease.

  3. Evaluation of antioxidant enzymes activity and malondialdehyde levels in patients with chronic periodontitis and diabetes mellitus.

    Science.gov (United States)

    Trivedi, Shilpa; Lal, Nand; Mahdi, Abbas Ali; Mittal, Madhukar; Singh, Babita; Pandey, Shivani

    2014-05-01

    The aim of this study is to investigate the impact of diabetes, a known risk factor for periodontitis, on activities of antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) as well as levels of free radical damage marker malondialdehyde (MDA) in blood and saliva of individuals with chronic periodontitis (CP). Sixty patients with CP (30 patients with type 2 diabetes mellitus [DMCP] and 30 systemically healthy patients [CP]) and 60 periodontally healthy individuals (30 patients with type 2 diabetes mellitus and 30 systemically healthy patients [PH]) were included in this study. After clinical measurements, blood and saliva samples were collected. SOD, GR, and CAT activities in red blood cell lysate and saliva and MDA levels in plasma and saliva samples were spectrophotometrically assayed. An analysis of variance test followed by a post hoc test was used to compare the intragroup and intergroup variances among the study groups. MDA levels in both the periodontitis groups were higher than in the periodontally healthy groups, but the difference between the CP and DMCP groups did not reach statistical significance (P >0.05). There was a highly significant difference between the CP and PH groups for all the enzymes studied except for SOD in blood. Only salivary SOD and GR activities were significantly different in the CP and DMCP groups. This study favors the role of oxidative stress in both diabetes and periodontitis. It shows that the compensatory mechanism of the body is partially collapsed because of excessive production of free radicals during periodontitis and is not able to cope with increased free radical generation attributable to diabetes, thereby worsening the situation.

  4. Duloxetine for the treatment of painful diabetic peripheral neuropathy in Venezuela: economic evaluation.

    Science.gov (United States)

    Carlos, Fernando; Espejel, Luis; Novick, Diego; López, Rubén; Flores, Daniel

    2015-09-25

    Painful diabetic peripheral neuropathy affects 40-50% of patients with diabetic neuropathy, leading to impaired quality of life and substantial costs. Duloxetine and pregabalin have evidence-based support, and are formally approved for controlling painful diabetic peripheral neuropathy. We used a 12-week decision model for examining painful diabetic peripheral neuropathy first-line therapy with daily doses of duloxetine 60mg or pregabalin 300mg, under the perspective of the Instituto Venezolano de los Seguros Sociales. We gathered model parameters from published literature and expert´s opinion, focusing on the magnitude of pain relief, the presence of adverse events, the possibility of withdrawal owing to intolerable adverse events or due to lack of efficacy, and the quality-adjusted life years expected in each strategy. We analyzed direct medical costs (which are expressed in Bolívares Fuertes, BsF) comprising drug acquisition besides additional care devoted to treatment of adverse events and poor pain relief. We conducted both deterministic and probabilistic sensitivity analyses. Total expected costs per 1000 patients were BsF 1 046 146 (26%) lower with duloxetine than with pregabalin. Most of these savings (91%) corresponds to the difference in the acquisition’s cost of each medication. duloxetine also provided 23 more patients achieving good pain relief and a gain of about two quality-adjusted life years per 1000 treated. Model was robust to plausible changes in main parameters. Duloxetine remained the preferred option in 93.9% of the second-order Monte Carlo simulations. This study suggests duloxetine dominates (i.e., is more effective and lead to gains in quality-adjusted life years), remaining less costly than pregabalin for treatment of painful diabetic peripheral neuropathy.

  5. History of Diabetes Insipidus.

    Science.gov (United States)

    Valenti, Giovanna; Tamma, Grazia

    2016-02-01

    Under physiological conditions, fluid and electrolyte homoeostasis is maintained by the kidney adjusting urine volume and composition according to body needs. Diabetes Insipidus is a complex and heterogeneous clinical syndrome affecting water balance and characterized by constant diuresis, resulting in large volumes of dilute urine. With respect to the similarly named Diabetes Mellitus, a disease already known in ancient Egypt, Greece and Asia, Diabetes Insipidus has been described several thousand years later. In 1670s Thomas Willis, noted the difference in taste of urine from polyuric subjects compared with healthy individuals and started the differentiation of Diabetes Mellitus from the more rare entity of Diabetes Insipidus. In 1794, Johann Peter Frank described polyuric patients excreting nonsaccharine urine and introduced the term of Diabetes Insipidus. An hystorical milestone was the in 1913, when Farini successfully used posterior pituitary extracts to treat Diabetes Insipidus. Until 1920s the available evidence indicated Diabetes Insipidus as a disorder of the pituitary gland. In the early 1928, De Lange first observed that some patients with Diabetes Insipidus did not respond to posterior pituitary extracts and subsequently Forssman and Waring in 1945 established that the kidney had a critical role for these forms of Diabetes Insipidus resistant to this treatment. In 1947 Williams and Henry introduced the term Nephrogenic Diabetes Insipidus for the congenital syndrome characterized by polyuria and renal concentrating defect resistant to vasopressin. In 1955, du Vigneaud received the 1955 Nobel Prize in chemistry for the first synthesis of the hormone vasopressin representing a milestone for the treatment of Central Diabetes Insipidus.

  6. The Evaluation of the Effectiveness of Austrians Disease Management Program in Patients with Type 2 Diabetes Mellitus - A Population-Based Retrospective Cohort Study

    OpenAIRE

    Regina Riedl; Martin Robausch; Andrea Berghold

    2016-01-01

    Aim To evaluate the effectiveness of the Austrian Disease Management Program (DMP) ?Therapie aktiv?Diabetes im Griff? for patients with type 2 diabetes mellitus concerning patient-relevant outcomes (mortality, myocardial infarction and stroke) and costs. Methods Based on routine health insurance data, we conducted a population-based retrospective cohort study using a propensity score (PS) matched control group design. The DMP-group consists of participants enrolled in the program during 2008 ...

  7. The palm print as a sensitive predictor of difficult laryngoscopy in diabetics: a comparison with other airway evaluation indices.

    Directory of Open Access Journals (Sweden)

    Vani V

    2000-04-01

    Full Text Available AIMS: To evaluate the ink impression made by the palm of the dominant hand as a screening tool for difficult laryngoscopy in diabetic patients. SUBJECTS AND METHODS: In this prospective study, airway of 50 adult diabetic patients, undergoing elective surgery under general anaesthesia, was assessed preoperatively using the common clinical indices such as Modified Mallampati test, thyromental distance, degree of head extension and a specific index- the palm print test. Following induction of anaesthesia and neuromuscular relaxation, laryngoscopy was performed and the laryngoscopic view scored. The sensitivity, specificity and positive predictive value of each airway evaluation index were calculated. RESULTS: The incidence of difficult laryngoscopy was 16%. The palm print test had the highest sensitivity (75% of all the indices. The thyromental distance less than six cm had the highest specificity (95.2% but was least sensitive (25%. 87% of patients with difficult laryngoscopy had two or more indices abnormal. CONCLUSION: Though the palm print test was the most sensitive index of the four indices studied, a better prediction of difficult laryngoscopy can be achieved by evaluating all the four airway indices preoperatively.

  8. Evaluation of antihyperglycaemic activity of Calotropis procera leaves extract on streptozotocin-induced diabetes in Wistar rats

    Directory of Open Access Journals (Sweden)

    Mário C. L. Neto

    Full Text Available Calotropis procera (Aiton W.T.Aiton,Apocynaceae, popularly known as "algodão-de-seda", is a wild African bush, rich in bioactive substances that determine the medicinal potential of this species. Diabetes mellitus is a disease that affects about 10% of the population. This study aimed to evaluate the antihyperglycaemic activity of the hydroalcoholic extract of the leaves of C. procera of occurrence in coast of Pernambuco, Brazil. The hydroalcholic extract of the leaves of C. procera (300 and 600 mg/kg/day, vehicle, insulin (6U, s.c. or metformin (500 mg/ kg/day were administered orally to streptozotocin-induced diabetic rats (n = 7/group for four weeks. Changes in body weight, food and water intake, biochemical markers, fasting glucose levels and oral glucose tolerance test were evaluated. The results showed that the C. procera dried extract (300 and 600 mg/kg reduced significantly the level of blood glucose throughout the evaluation period and improved metabolic status of the animals and ameliorate the oral tolerance glucose test. The phytochemical screening revealed and quantified the presence of phenolic compounds and flavonoids in a percentage of 29.1 and 2.9%, respectively. Thus, we conclude that the extract of the leaves of C. procera has antihyperglycemic activity.

  9. MOTORIZATION IN ASIA

    Directory of Open Access Journals (Sweden)

    Metin SENBIL

    2007-01-01

    Full Text Available Motorization in terms of passenger cars in 14 Asian countries and passenger cars and motorcycles in three metropolitan areas are analyzed in this study. Using country-based data which cover 20 years (1980–2000, a linear regression is conducted by panel estimation with random and fixed effects. As a result from the model, fixed income elasticity for the region was found to be 1.75. Fixed effect estimated separately for each country characterizes the motorization pace in the countries. Two groups of countries were detected with a significant difference in motorization paces—Sri Lanka, India, Nepal, Philippines, Pakistan, Indonesia and Thailand have motorization paces higher than the rest of the countries. Additionally, using a cross-sectional data household car and motorcycle ownerships were analyzed for three metropolitan areas characterizing South-East Asia that are Jabotabek (Indonesia, Kuala Lumpur (Malaysia and Manila (Philippines metropolitan areas. Results indicate that ownership of cars and motorcycles are independent of each other in Jabotabek and Manila, but negatively correlated in Kuala Lumpur; and generally, income is more influential on car ownership than motorcycle ownership.

  10. Göttingen minipig model of diet-induced atherosclerosis: influence of mild streptozotocin-induced diabetes on lesion severity and markers of inflammation evaluated in obese, obese and diabetic, and lean control animals

    DEFF Research Database (Denmark)

    Ludvigsen, Trine Pagh; Kirk, Rikke Kaae; Christoffersen, Berit Østergaard

    2015-01-01

    From a pharmacological perspective, readily-available, well-characterized animal models of cardiovascular disease, including relevant in vivo markers of atherosclerosis are important for evaluation of novel drug candidates. Furthermore, considering the impact of diabetes mellitus on atherosclerosis...... in human patients, inclusion of this disease aspect in the characterization of a such model, is highly relevant. The objective of this study was to evaluate the effect of mild streptozotocin-induced diabetes on ex- and in vivo end-points in a diet-induced atherosclerotic minipig model. Castrated male...... Göttingen minipigs were fed standard chow (CD), atherogenic diet alone (HFD) or with superimposed mild streptozotocin-induced diabetes (HFD-D). Circulating markers of inflammation (C-reactive protein (CRP), oxidized low-density lipoprotein (oxLDL), plasminogen activator inhibitor-1, lipid and glucose...

  11. Asia’s China Debate

    Science.gov (United States)

    2003-12-01

    defined to include Southeast Asia ). It dwarfed its neighbors in area and population . Its economy was the largest in the world and included a thriving...the eventual goal of linking the two. Given the size of its economy, military power, population and geographic presence in or proximity to East Asia ...Russia that Moscow’s control will snap under the pressure of demography. Russia’s population east of Lake Baikal is less than eight million. China’s

  12. Southeast Asia Report. No. 1325

    Science.gov (United States)

    1983-08-15

    former Bank Negara Governor Tun Is- mail Ali, former Finance Minister Tun Tan Siew Sin, bankers and mem- bers of the diplomatic corp. , The Prime...286100 JPRS 84128 15 August 1983 Southeast Asia Report No. 1325 19980609 126 <#*.. % %, FBIS FOREIGN BROADCAST INFORMATION SERVICE...34 ■" ’ ’ ’ ■ ■■■■ ■■ .i.i Approved for public release? . Distribution Unlimited „. /4$5" JPRS 84128 15 August 1983 Southeast Asia Report No. 1325

  13. Multi-year downscaling application of two-way coupled WRF v3.4 and CMAQ v5.0.2 over east Asia for regional climate and air quality modeling: model evaluation and aerosol direct effects

    Science.gov (United States)

    Hong, Chaopeng; Zhang, Qiang; Zhang, Yang; Tang, Youhua; Tong, Daniel; He, Kebin

    2017-06-01

    In this study, a regional coupled climate-chemistry modeling system using the dynamical downscaling technique was established by linking the global Community Earth System Model (CESM) and the regional two-way coupled Weather Research and Forecasting - Community Multi-scale Air Quality (WRF-CMAQ) model for the purpose of comprehensive assessments of regional climate change and air quality and their interactions within one modeling framework. The modeling system was applied over east Asia for a multi-year climatological application during 2006-2010, driven with CESM downscaling data under Representative Concentration Pathways 4.5 (RCP4.5), along with a short-term air quality application in representative months in 2013 that was driven with a reanalysis dataset. A comprehensive model evaluation was conducted against observations from surface networks and satellite observations to assess the model's performance. This study presents the first application and evaluation of the two-way coupled WRF-CMAQ model for climatological simulations using the dynamical downscaling technique. The model was able to satisfactorily predict major meteorological variables. The improved statistical performance for the 2 m temperature (T2) in this study (with a mean bias of -0.6 °C) compared with the Coupled Model Intercomparison Project Phase 5 (CMIP5) multi-models might be related to the use of the regional model WRF and the bias-correction technique applied for CESM downscaling. The model showed good ability to predict PM2. 5 in winter (with a normalized mean bias (NMB) of 6.4 % in 2013) and O3 in summer (with an NMB of 18.2 % in 2013) in terms of statistical performance and spatial distributions. Compared with global models that tend to underpredict PM2. 5 concentrations in China, WRF-CMAQ was able to capture the high PM2. 5 concentrations in urban areas. In general, the two-way coupled WRF-CMAQ model performed well for both climatological and air quality applications. The coupled

  14. Multi-year downscaling application of two-way coupled WRF v3.4 and CMAQ v5.0.2 over east Asia for regional climate and air quality modeling: model evaluation and aerosol direct effects

    Directory of Open Access Journals (Sweden)

    C. Hong

    2017-06-01

    Full Text Available In this study, a regional coupled climate–chemistry modeling system using the dynamical downscaling technique was established by linking the global Community Earth System Model (CESM and the regional two-way coupled Weather Research and Forecasting – Community Multi-scale Air Quality (WRF-CMAQ model for the purpose of comprehensive assessments of regional climate change and air quality and their interactions within one modeling framework. The modeling system was applied over east Asia for a multi-year climatological application during 2006–2010, driven with CESM downscaling data under Representative Concentration Pathways 4.5 (RCP4.5, along with a short-term air quality application in representative months in 2013 that was driven with a reanalysis dataset. A comprehensive model evaluation was conducted against observations from surface networks and satellite observations to assess the model's performance. This study presents the first application and evaluation of the two-way coupled WRF-CMAQ model for climatological simulations using the dynamical downscaling technique. The model was able to satisfactorily predict major meteorological variables. The improved statistical performance for the 2 m temperature (T2 in this study (with a mean bias of −0.6 °C compared with the Coupled Model Intercomparison Project Phase 5 (CMIP5 multi-models might be related to the use of the regional model WRF and the bias-correction technique applied for CESM downscaling. The model showed good ability to predict PM2. 5 in winter (with a normalized mean bias (NMB of 6.4 % in 2013 and O3 in summer (with an NMB of 18.2 % in 2013 in terms of statistical performance and spatial distributions. Compared with global models that tend to underpredict PM2. 5 concentrations in China, WRF-CMAQ was able to capture the high PM2. 5 concentrations in urban areas. In general, the two-way coupled WRF-CMAQ model performed well for both climatological and air

  15. Diabetes among migrants in Denmark

    DEFF Research Database (Denmark)

    Andersen, Gregers Stig; Kamper-Jørgensen, Zaza; Carstensen, Bendix

    2016-01-01

    OBJECTIVE: Studies of diabetes in migrant populations have shown a higher prevalence compared to their respective countries of origin and to people natively born in the host country, but there is little population-based data on diabetes incidence and mortality in migrant populations. The aim...... of the current study was (1) to describe the incidence rates and prevalence of diabetes among first generation migrants in Denmark compared to the Danish background population, and (2) to compare standardised mortality rates (SMRs) for individuals with and without diabetes according to country of origin...... to the part of the population without diabetes were calculated based on follow up of the entire Danish population. RESULTS: Compared with native born Danes, the incidence of diabetes was about 2.5 times higher among migrants from Africa, Asia, and the Middle East, and these migrant groups also showed...

  16. Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus.

    Science.gov (United States)

    Kupfer, Rosane; Larrúbia, Manuella Rangel; Bussade, Isabela; Pereira, Joana Rodrigues Dantas; Lima, Giovanna A Balarini; Epifanio, Marcio Antonio; Schettino, Claudio Domenico Sahione; Momesso, Denise Prado

    2017-01-01

    This study aimed to evaluate the occurrence and clinical predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM. The study included 45 women with type 1 diabetes mellitus (DM) (aged 36 ± 9 years) who underwent carotid Doppler ultrasound evaluation to determine the carotid artery intima-media thickness (CIMT) and to assess the occurrence of carotid artery plaques. Insulin sensitivity was assessed by estimated glucose disposal rate (eGDR), and metabolic syndrome (MS) was defined by the World Health Organization criteria. The cohort had a mean age of 36 ± 9 years, diabetes duration of 18.1 ± 9.5 years, and body mass index (BMI) of 24.6 ± 2.4 kg/m2. MS was present in 44.4% of the participants. The CIMT was 0.25 ± 0.28 mm, and the prevalence of carotid artery plaques was 13%. CIMT correlated positively with hypertension (p = 0.04) and waist-to-hip ratio (r = 0.37, p = 0.012). The presence of carotid artery plaques correlated positively with age (p = 0.018) and hypertension (p = 0.017). eGDR correlated negatively with CIMT (r = -0.39, p = 0.009) and carotid plaques (p = 0.04). Albuminuria showed a correlation trend with CIMT (p = 0.06). Patients with carotid artery plaques were older, had a higher prevalence of hypertension, and lower eGDR. No correlation was found between CIMT and carotid plaques with diabetes duration, MS, BMI, cholesterol profile, glycated hemoglobin, high-sensitivity C-reactive protein, or fibrinogen. Insulin resistance, central obesity, hypertension, and older age were predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM.

  17. Evaluation of vitreous levels of advanced glycation end products and angiogenic factors as biomarkers for severity of diabetic retinopathy.

    Science.gov (United States)

    Katagiri, Makiko; Shoji, Jun; Inada, Noriko; Kato, Satoshi; Kitano, Shigehiko; Uchigata, Yasuko

    2017-03-15

    Glyceraldehyde-derived advanced glycation end products (glycer-AGE; also called Toxic-AGE [TAGE]) play a crucial role in the pathogenesis of diabetic angiopathy. However, the relationships between vitreous glycer-AGE levels and diabetic retinopathy (DR) severity, and between glycer-AGE levels and the levels of other angiogenic factors remain unknown. We investigated the correlation between levels of vitreous biomarkers, including glycer-AGE and angiogenic factors (vascular endothelial growth factor [VEGF], interleukin [IL]-8, leptin, placental growth factor [PlGF], endoglin, and fibroblast growth factor [FGF]-2) in patients with DR, using three DR staging groups. In this cross-sectional study, we examined 33 eyes from 33 patients with diabetes mellitus who underwent a vitrectomy (non-proliferative DR [NPDR, n = 8]; PDR with simple vitreous haemorrhage [VH, n = 17]; or PDR with a fibrovascular proliferative membrane [FVM, n = 8]). Vitreous levels of glycer-AGE and VEGF were evaluated using enzyme-linked immunosorbent assays. Vitreous levels of IL-8, leptin, PlGF, endoglin, and FGF-2 were evaluated using beaded assay methods. Vitreous levels of glycer-AGE in the FVM group were significantly higher than those in the NPDR and VH groups (all p Vitreous levels of VEGF (r = 0.85, p = 1.7 × 10-6) and leptin (r = 0.60, p = 5.0 × 10-3) were significantly correlated with levels of PlGF. The two systems (VEGF-PlGF-leptin and glycer-AGE) were represented in these measured biomarkers. High vitreous levels of both VEGF and glycer-AGE may be linked to more severe DR, suggesting that anti-VEGF and anti-TAGE therapy may be an important part of the therapeutic strategy for DR.

  18. A preliminary evaluation of optometric management and referral protocols for pa-tients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    M. Mehta

    2005-01-01

    Full Text Available Aim: The purpose of this pilot study was to investigate  the  assessment,  management  and referral practices of South African optometrists in  the  care  of  patients  with  diabetic  retinop-athy  (DR  and  to  recommend  strategies  to improve  and  standardize  patient  management as required.  Methods:  The  study  design  incorporated quantitative,  qualitative  and  clinical  measures that were administered to fourteen experienced optometrists from the Durban area. The quan-titative measure, the questionnaire in appendix I, evaluated the optometrists’ management pro-tocols of patients with diabetes mellitus (DM.  These  included  the  optometrists’  referral  and co-management practices, their awareness and usage  of  appropriate  guidelines  in  the  man-agement  and  referral  of  these  patients,  their perceived levels of competence and confidence in their education, levels of service offered to the patients and finally the role of Continuous Professional  Development  (CPD.  This  self-report information was supplemented by a set of clinical measures where the study sample grad-ed levels of DR, chose appropriate management options  and  indicated  prognosis  for  disease progression based on a set of slides presented to  them.  Finally  the  fourteen  optometrists,  as well as two ophthalmologists, were interviewed using tailored, semi-structured interview sched-ules. These interviews were used to elaborate and corroborate information obtained from the other two research approaches.  Results:  Descriptive  analysis  was  used  to analyse  the  data  from  the  quantitative  and clinical  measures,  whilst  the  interviews  were analysed  thematically.  Although  86%  of  the sample routinely screened for ocular manifesta-tions of DM, there was no standardization in the criteria used by the fourteen optometrists

  19. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Cuadros JA

    2015-06-01

    Full Text Available Jorge A Cuad