Rooting of jade vine (Strongylodon macrobotrys A. Gray cuttings treated with indolbutiric acid

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Fabiana Rezende Muniz

2015-12-01

Full Text Available The jade vine (Strongylodon macrobotrys A. Gray, is native plant from Philippines. It has long blue-green pseudoracemes inflorescence, which makes it unique and incomparable. It is considered one of the most admired and sought vines, although rare in gardens. This study evaluated the effect of indolbutiric acid (IBA on the stalks rooting of this ornamental specie. Stem cuttings without leaves and with a couple of leaves cut in half, were collected from branches of a well developed jade vine plant and were immerged into dipping solutions with a concentration range of IBA (0, 500, 1.000, 2.000 and 4.000 mg L-1 for 15 seconds. Subsequently, the bases of the cuttings was planted in polystyrene trays containing vermiculite (one cutting per cell and maintained in an intermittent water mist chamber for a 80 days period. Then the percentage of stem rooting was assessed as well as the number of roots and the length of the main root. Jade vine plants can be produced byr stem cutting treated in a dipping solution containing an IBA concentration of 2.000 mg L-1.

"Jade Warrior" sai Hispaanias kolm preemiat

Index Scriptorium Estoniae

2007-01-01

Eesti osalusega Soome-Hiina kung fu film "Igavese armastuse sõdalane - Jade Warrior" võitis 1. Ibiza ja Formentera filmifestivalil kolm Falco d'Ori auhinda (AJ Annila - parim debüüt-lavastaja, Jukka Uusitalo - filmikunstniku töö eest, Henri Blomberg - operaatritöö eest)

Eesti filmi "Jade Warrior" esilinastus Torontos / Andres Laasik

Index Scriptorium Estoniae

Laasik, Andres, 1960-2016

2006-01-01

Soome ja Hiina mütoloogiat ühendav fantaasiafilm "Igavese armastuse sõdalane - Jade Warrior" (Soome, Hiina ja Eesti ühistöö) esilinastus eile Toronto filmifestivalil. Andmed filmi tootmise ja levitamise kohta

Discovery of the Earliest Synthetic Carborundum (SiC in Neolithic Jade Artifacts in Eastern China

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Su-Jung Chou

2014-01-01

Full Text Available Using Raman microscopy and scanning electron microscopy we have successfully identified, for the first time, synthetic silicon carbide (carborundum particles in 15 unearthed relics and assorted remains from five out of six Neolithic sites (~4000 - 7000 years b.p. in Eastern China. Because of its extreme hardness, silicon carbide was apparently employed in the manufacture of ancient jade artifacts presumably as an abrasive for polishing. We show that Neolithic people may have already used this synthetic material to carve and polish both jade and quartz artifacts, contributing to the blooming development of the jade culture throughout ancient China.

Online event filtering in the JADE data acquisition system

International Nuclear Information System (INIS)

Mills, H.E.

1986-01-01

The data acquisition system developed for the JADE experiment at PETRA, DESY includes the facility to use software to filter out background events. The design, implementation, testing and experience gained are discussed. (orig.)

泰山玉的外观特征及分类分级研究%Study on Appearance and Classification of Taishan Jade

Institute of Scientific and Technical Information of China (English)

张念朋; 李宗成; 邢楠

2015-01-01

The color of Taishan jade are mainly green, black, brown, and flower color. According to the color of jade, combing with specific names generally accepted by the market, Taishan jade can be divided into 4 types, namely Taishan jasper, Taishan jade, Taishan cappuccino and Taishan Huabanyu. In this paper, quality evaluation of Taishan jade has been carried out from colour, texture, transparency, luster, clarity and block degree, and ever?y jade type has been divided into three quality grades.%泰山玉的主要矿物成分为蛇纹石,另外有少量的磁铁矿、绿泥石等,因其所含矿物及其含量的不同,产生了不同的外观特征. 泰山玉的颜色主要有绿色、黑色、褐色和花色4个系列,根据玉石颜色结合市场上普遍认可的分类名称,将泰山玉划分为4类,即泰山碧玉、泰山墨玉、泰山紫檀玉和泰山花斑玉. 从颜色、质地、透明度、光泽、净度、块度几方面对泰山玉进行了质量评价,并将每一玉石类型划分了3个质量等级.

Jade aus Amerika und weitere Grünsteinobjekte von Alexander von Humboldt aus dem Berliner Mineralienkabinett

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Renate Nöller

2002-04-01

Full Text Available Article in German, Abstracts in English, Spanish and German.Alexander von Humboldt sent samples of minerals from America not only for scientific or economic purposes. We also find carved pieces made out of green stone material known as Jade, that has been culturally very important in Mesoamerica. In Europe these green stone objects have been treated differently. The Jade-Celt and the Sun-Disc - known as “Humboldt-Axt” and “Humboldt-Scheibe” - both lost during the second world war, had gained great interest, whereas a small head-pendant - made out of Jade has been totally forgotten. The samples reflect the understanding of their worth in distinct cultural contexts.

[The Non-Destructive Analysis of Some Ancient Jade Artifacts Unearthed from Henan Province by a Variety of Optical Techniques].

Science.gov (United States)

Wang, Kai; Dong, Jun-qing; Zhao, Hong-xia; Gan, Fu-xi; Hu, Yong-qing; Pan, Wen-quan

2015-09-01

A total of 14 pieces of ancient jade artifact unearthed from Henan Province were non-destructively analyzed by means of a portable X-ray fluorescence spectrometer (pXRF), laser Raman spectroscopy (portable and mobile) and optical coherence tomography (OCT) technology, comprehensively. The raw materials of ancient jade artifacts could be determined accurately through the combination of pXRF and portable Raman spectrometer in a short time. With the advantages of small size and easy-operation, these two instruments are suitable to in situ non-destructive analysis of ancient jade artifacts. The results of the pXRF shows that these ancient jade artifacts can be divided into 6 categories such as rich in Si Al K, rich in Ca, rich in Si Ca, rich in Si Mg, rich in Si, rich in Ca P. Their main phases have been successfully identified by the portable Raman spectrometer. In the lab, the mobile confocal laser Raman spectrometer, which help us find the Raman vibration peak of [OH] in the tremolite jade, is used to make up the disadvantages of the portable Raman spectrometer such as lower spectral resolution, lower accuracy and narrower measuring range. We can use the OCT to analyze the transparency, fiber fineness and inclusion etc. of the jade artifacts. The confocal laser Raman spectroscopy combined with OCT is used to analyze 2 containing inclusion of tremolite jade samples. OCT image can visually display the distribution characteristics of the inclusion in these 2 samples. Confocal laser Raman spectroscopy can accurately locate the sample surface of inclusion, then we can observe the micro morphology and analyze its phase. The results show that the black inclusion is graphite. This work is very significant to study the geographical origin of jade. Through the study we find, the use of pXRF, laser Raman spectroscopy (portable and mobile) and OCT can be achieved on the identification and analysis of cultural relic's phase composition and texture feature and meet the basic

Hydrothermal regime and constraints on reservoir depth of the Jade site in the Mid-Okinawa Trough inferred from heat flow measurements

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Kinoshita, Masataka; Yamano, Makoto

1997-02-01

Detailed heat flow measurements revealed an enormous heat flow variation (102 to 105 mW m-2) in the Jade hydrothermal field (27°16'N, 127°05'E and water depth 1350 m) located on the slope of the Izena Hole in the Mid-Okinawa Trough. Within the Jade site, heat flow is higher than 1000 mW m-2 and decreases to ˜100 mW m-2 with a 1 km horizontal scale. Near the Jade black smoker, heat flow varies from >30,000 mW m-2 at a hydrothermally altered area to 1700 mW m-2 less than 100 m from it. A large-scale heat flow variation suggests that the base of the escarpment near the Jade site serves as a recharge area for the Jade site. Linear geotherms indicate that the upward Darcian flow within sediments is slower than ˜3 cm yr-1. Thus the fluid circulation pathways would basically be restricted in permeable channels. Estimated conductive heat output rate from the Jade site is 4-7 MW, which is comparable to heat output by a single black smoker vent (˜8 MW). One-dimensional thermal modeling predicts the existence of a boiling zone at ˜200 m beneath the Jade site, which may be overlain by a fractured impermeable layer. The normal chloride content of venting fluids from the black smoker may be explained either by upwelling of fluid which boiled at shallow depth but suffered no phase segregation, or by upwelling of fluid above the boiling interface.

Investigation of Chinese archaic jade by PIXE and μRaman spectrometry

International Nuclear Information System (INIS)

Chen, T.H.; Calligaro, T.; Pages-Camagna, S.; Menu, M.

2004-01-01

External-beam particle-induced X-ray emission (PIXE) and μRaman spectrometry were used for elemental and structural studies of Chinese archaic nephrite jades of the Guimet Asian Museum in Paris in a non-destructive way. Nephrite is a variety of tremolite-actinolite of the amphibole group, with variable iron and magnesium contents. In the present work, in addition to identification of materials, the cation distribution in nephrite was investigated. Cation order-disorder is related to thermodynamic properties of minerals, and hence associated with geological conditions of the mineral formation. Besides, it plays an important role in the mechanism of coloration. So far, little work has been done on the cation distribution in nephrite. We thus initiated this research expecting to answer open questions concerning art and archaeological issues such as jade provenance and colour. The OH stretching vibration band of nephrite, depending on the electronegativity of the bonded cations, presents a fine structure. The study of this fine structure, together with the total cation content obtained by PIXE, allows estimation of the cation distribution in nephrite. In this study, six jade artefacts, dated from the Neolithic period to the Han dynasty (about 3000 BC to 220 AD), with diverse colours including white, yellow-green, green, dark green and black, were analysed. The data obtained permits establishing a geological database for determination of nephrite provenance and explaining the correlation between colour and cation distribution. (orig.)

Latitudinal distribution of the Jovian plasma sheet ions observed by Juno JADE-I

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Kim, T. K. H.; Valek, P. W.; McComas, D. J.; Allegrini, F.; Bagenal, F.; Bolton, S. J.; Connerney, J. E. P.; Ebert, R. W.; Levin, S.; Louarn, P.; Pollock, C. J.; Ranquist, D. A.; Szalay, J.; Thomsen, M. F.; Wilson, R. J.

2017-12-01

The Jovian plasma sheet is a region where the centrifugal force dominates the heavy ion plasma. Properties of the plasma sheet ions near the equatorial plane have been studied with in-situ measurements from the Pioneer, Voyager, and Galileo spacecraft. However, the ion properties for the off-equator regions are not well known due to the limited measurements. Juno is the first polar orbiting spacecraft that can investigate the high latitude region of the Jovian magnetosphere. With Juno's unique trajectory, we will investigate the latitudinal distribution of the Jovian plasma sheet ions using measurements from the Jovian Auroral Distributions Experiment Ion sensor (JADE-I). JADE-I measures an ion's energy-per-charge (E/Q) from 0.01 keV/q to 46.2 keV/q with an electrostatic analyzer (ESA) and a mass-per-charge (M/Q) up to 64 amu/q with a carbon-foil-based time-of-flight (TOF) mass spectrometer. We have shown that the ambiguity between and (both have M/Q of 16) can be resolved in JADE-I using a semi-empirical simulation tool based on carbon foil effects (i.e., charge state modification, angular scattering, and energy loss) from incident ions passing through the TOF mass spectrometer. Based on the simulation results, we have developed an Ion Composition Analysis Tool (ICAT) that determines ion composition at each energy step of JADE-I (total of 64 steps). The velocity distribution for each ion species can be obtained from the ion composition as a function of each energy step. Since there is an ambipolar electric field due to mobile electrons and equatorially confined heavy ions, we expect to see acceleration along the field line. This study will show the species separated velocity distribution at various latitudes to investigate how the plasma sheet ions evolve along the field line.

"Jade Warrior" kupatab Soome sampo Hiina / Kätlin Kaldmaa

Index Scriptorium Estoniae

Kaldmaa, Kätlin, 1970-

2006-01-01

Soome ja Hiina mütoloogiat ühendav fantaasiafilm "Igavese armastuse sõdalane - Jade Warrior" (Soome, Hiina, Hollandi ja Eesti ühistöö) : stsenarist Iiro Küttner : režissöör Antti-Jussi Annila : võitluskunstide koreograaf Yu Yan Kai : osades Tommi Eronen, Zhang Jingchu, Markku Peltola. Lisatud Ave Randviiru, Elle Kulli ja Antti-Jussi Annila "Esimesed muljed"

The data acquisition system for the JADE detector

International Nuclear Information System (INIS)

Cords, D.; Dittmann, P.; Eichler, R.; Mills, H.E.

1985-07-01

An outline of the data acquisition system for the JADE experiment at PETRA, DESY is presented. After describing the hardware configuration, we describe our guiding ideas for the design of the data acquisition system, which is followed by accounts of the implementation of real time software, the data flow, the monitoring and detector control as well as the online event analysis and filtering. Finally we summarise our experience with the system. (orig.)

Cold blobs of protons in Jupiter's outer magnetosphere as observed by Juno's JADE

Science.gov (United States)

Wilson, R. J.; Bagenal, F.; Valek, P. W.; Allegrini, F.; Angold, N. G.; Chae, K.; Ebert, R. W.; Kim, T. K. H.; Loeffler, C.; Louarn, P.; McComas, D. J.; Pollock, C. J.; Ranquist, D. A.; Reno, C.; Szalay, J. R.; Thomsen, M. F.; Weidner, S.; Bolton, S. J.; Levin, S.

2017-12-01

Juno's 53-day polar orbits cut through the equatorial plane when inbound to perijove. The JADE instrument has been observing thermal ions (0.01-50 keV/q) and electrons (0.1-100 keV/q) in these regions since Orbit 05. Even at distances greater than 70 RJ, magnetodisk crossings are clear with high count rates measured before returning to rarified plasma conditions outside the disk. However JADE's detectors observes regions of slightly greater ion counts that last for about an hour. The ion counts are too low to analyze at the typical 30s or 60s low rate instrument cadence, but by summing to 10-minute resolution the features become analyzable. We find these regions are populated with protons with higher density than those typically observed outside the magnetodisk, and that they are colder than the ambient plasma. Reanalysis of Voyager data (DOI: 10.1002/2017JA024053) also showed cold dense blobs of plasma in the inner to middle magnetosphere, however these were of heavier ion species, short lived (several minutes) and within 40 RJ of Jupiter. This presentation will investigate the JADE identified cold blobs observed to date and compare with those observed with Voyager.

An On-the-Fly Surface-Hopping Program JADE for Nonadiabatic Molecular Dynamics of Polyatomic Systems: Implementation and Applications.

Science.gov (United States)

Du, Likai; Lan, Zhenggang

2015-04-14

Nonadiabatic dynamics simulations have rapidly become an indispensable tool for understanding ultrafast photochemical processes in complex systems. Here, we present our recently developed on-the-fly nonadiabatic dynamics package, JADE, which allows researchers to perform nonadiabatic excited-state dynamics simulations of polyatomic systems at an all-atomic level. The nonadiabatic dynamics is based on Tully's surface-hopping approach. Currently, several electronic structure methods (CIS, TDHF, TDDFT(RPA/TDA), and ADC(2)) are supported, especially TDDFT, aiming at performing nonadiabatic dynamics on medium- to large-sized molecules. The JADE package has been interfaced with several quantum chemistry codes, including Turbomole, Gaussian, and Gamess (US). To consider environmental effects, the Langevin dynamics was introduced as an easy-to-use scheme into the standard surface-hopping dynamics. The JADE package is mainly written in Fortran for greater numerical performance and Python for flexible interface construction, with the intent of providing open-source, easy-to-use, well-modularized, and intuitive software in the field of simulations of photochemical and photophysical processes. To illustrate the possible applications of the JADE package, we present a few applications of excited-state dynamics for various polyatomic systems, such as the methaniminium cation, fullerene (C20), p-dimethylaminobenzonitrile (DMABN) and its primary amino derivative aminobenzonitrile (ABN), and 10-hydroxybenzo[h]quinoline (10-HBQ).

Project JADE. Comparison of repository systems. Executive summary of results

International Nuclear Information System (INIS)

Sandstedt, H.; Pers, K.; Birgersson, Lars; Ageskog, L.; Munier, R.

2001-12-01

KBS-3 has since 1984 been the reference method for disposal of spent fuel in Sweden. Several other methods like WP-Cave, Very Deep Holes and Very Long Holes have been evaluated and compared with KBS-3. Though the methods have been judged to have a high safety potential, KBS-3 has been shown to provide advantages in the combined judgement of 'long-term performance and safety', 'technology' and 'costs'. In the present study, different variants of the KBS-3 method have been analysed and compared with the reference concept KBS-3 V (V for vertical). The variants are: KBS-3 H (H for horizontal) and MLH (medium long holes) - with canisters in a horizontal position, single or in a row respectively. The comparison has been carried out separately for the interim items 'technology', 'long-term performance and safety' and 'costs' respectively. The outcome in each of these comparisons have finally been combined in a ranking. This ranking placed KBS-3 V in the top followed by MLH and KBS-3 H. Vertical deposition of a single canister in one deposition hole, KBS-3 V, is robust as gravity is used for lowering the canister and the bentonite into the deposition hole and since each canister has its own barrier in the near field, which reduces the risk for interference between canisters. The drawback for MLH is the uncertainty about the emplacement technique as well as the impact of weak rock and water leakage into a long deposition hole for several canisters. The advantage is that a smaller volume of rock has to be excavated. This is positive regarding the long-term performance and safety, environmental impact and costs. KBS-3 H does not have the same positive potential. The conclusion of the JADE study is that KBS-3 V should remain as reference concept, and that MLH should be studied further with the aim of clarifying the technical feasibility of emplacement and the means of handling water inflow. It is recommended that KBS-3 H with deposition of a single canister in each hole should

Comparison of JADE and canonical correlation analysis for ECG de-noising.

Science.gov (United States)

Kuzilek, Jakub; Kremen, Vaclav; Lhotska, Lenka

2014-01-01

This paper explores differences between two methods for blind source separation within frame of ECG de-noising. First method is joint approximate diagonalization of eigenmatrices, which is based on estimation of fourth order cross-cummulant tensor and its diagonalization. Second one is the statistical method known as canonical correlation analysis, which is based on estimation of correlation matrices between two multidimensional variables. Both methods were used within method, which combines the blind source separation algorithm with decision tree. The evaluation was made on large database of 382 long-term ECG signals and the results were examined. Biggest difference was found in results of 50 Hz power line interference where the CCA algorithm completely failed. Thus main power of CCA lies in estimation of unstructured noise within ECG. JADE algorithm has larger computational complexity thus the CCA perfomed faster when estimating the components.

Extraction and Production of Omega-3 from UniMAP Puyu (Jade Perch) and Mackarel

Science.gov (United States)

Nur Izzati, I.; Zainab, H.; Nornadhiratulhusna, M.; Chee Hann, Y.; Khairunissa Syairah, A. S.; Amira Farzana, S.

2018-03-01

Extraction techniques to extract fish oil from various types of fish are numerous but not widely accepted because of the use of chemicals that may be harmful to health. In this study, fish oil is extracted using a technique of Microwave-Assisted Extraction, which uses only water. The optimum conditions required for the production of fish oil for extraction is carried out by examining three parameters such as microwave power (300-700W), extraction time (10-30 min) and amount of water used (70-190ml). Optimum conditions were determined after using design of experiments (DOE). The optimum condition obtained was 300 W for microwave power, 10 minutes extraction time and 190 milliliter amounts of water used. Fourier transform infrared spectroscopy (FTIR) was used to analyze the functional groups of fish oil. Two types of fish such as Jade Perch or UniMAP Puyu and Indian Mackerel were used. A standard omega-3 oil sample (Blackmores) purchased from pharmacy was also determined to confirm the presence of omega-3 oil in these fishes. Similar compounds were present in Jade Perch and Indian Mackerel as compared to the standard. Therefore, there were presence of omega-3 fish oil in the two types of fish. From this study, omega-3 in UniMAP Puyu fish was higher compared to Indian Mackerel fish. However, based on the FTIR analysis, besides the presence of omega-3, the two fishes also contain other functional groups such as alkanes, alkenes, aldehyde, ketones and many others. The yield of fish oil for the Jade Perch was low compared to Indian Mackerel which was 9% while Indian Mackerel was 10 %.

Brain Aging and AD-Like Pathology in Streptozotocin-Induced Diabetic Rats

Directory of Open Access Journals (Sweden)

Jian-Qin Wang

2014-01-01

Full Text Available Objective. Numerous epidemiological studies have linked diabetes mellitus (DM with an increased risk of developing Alzheimer’s disease (AD. However, whether or not diabetic encephalopathy shows AD-like pathology remains unclear. Research Design and Methods. Forebrain and hippocampal volumes were measured using stereology in serial coronal sections of the brain in streptozotocin- (STZ- induced rats. Neurodegeneration in the frontal cortex, hypothalamus, and hippocampus was evaluated using Fluoro-Jade C (FJC. Aβ aggregation in the frontal cortex and hippocampus was tested using immunohistochemistry and ELISA. Dendritic spine density in the frontal cortex and hippocampus was measured using Golgi staining, and western blot was conducted to detect the levels of synaptophysin. Cognitive ability was evaluated through the Morris water maze and inhibitory avoidant box. Results. Rats are characterized by insulin deficiency accompanied with polydipsia, polyphagia, polyuria, and weight loss after STZ injection. The number of FJC-positive cells significantly increased in discrete brain regions of the diabetic rats compared with the age-matched control rats. Hippocampal atrophy, Aβ aggregation, and synapse loss were observed in the diabetic rats compared with the control rats. The learning and memory of the diabetic rats decreased compared with those of the age-matched control rats. Conclusions. Our results suggested that aberrant metabolism induced brain aging as characterized by AD-like pathologies.

Brain Aging and AD-Like Pathology in Streptozotocin-Induced Diabetic Rats

Science.gov (United States)

Wang, Jian-Qin; Yin, Jie; Song, Yan-Feng; Zhang, Lang; Ren, Ying-Xiang; Wang, De-Gui; Gao, Li-Ping; Jing, Yu-Hong

2014-01-01

Objective. Numerous epidemiological studies have linked diabetes mellitus (DM) with an increased risk of developing Alzheimer's disease (AD). However, whether or not diabetic encephalopathy shows AD-like pathology remains unclear. Research Design and Methods. Forebrain and hippocampal volumes were measured using stereology in serial coronal sections of the brain in streptozotocin- (STZ-) induced rats. Neurodegeneration in the frontal cortex, hypothalamus, and hippocampus was evaluated using Fluoro-Jade C (FJC). Aβ aggregation in the frontal cortex and hippocampus was tested using immunohistochemistry and ELISA. Dendritic spine density in the frontal cortex and hippocampus was measured using Golgi staining, and western blot was conducted to detect the levels of synaptophysin. Cognitive ability was evaluated through the Morris water maze and inhibitory avoidant box. Results. Rats are characterized by insulin deficiency accompanied with polydipsia, polyphagia, polyuria, and weight loss after STZ injection. The number of FJC-positive cells significantly increased in discrete brain regions of the diabetic rats compared with the age-matched control rats. Hippocampal atrophy, Aβ aggregation, and synapse loss were observed in the diabetic rats compared with the control rats. The learning and memory of the diabetic rats decreased compared with those of the age-matched control rats. Conclusions. Our results suggested that aberrant metabolism induced brain aging as characterized by AD-like pathologies. PMID:25197672

Project JADE. Description of the MLH-method

International Nuclear Information System (INIS)

Sandstedt, H.; Munier, R.; Wichmann, C.; Isaksson, Therese

2001-08-01

This report constitutes a part of a series of reports within project JADE, comparison of deposition methods. A comparison of the deposition methods MLH (Medium Long Holes with approximately 25 copper canisters emplaced in a horizontal deposition hole about 200 metres in length bored between central and side tunnels) and KBS-3 (copper canisters are emplaced in vertical deposition holes bored in the floors of horizontal tunnels) has earlier been performed and KBS-3 was judged to be more advantageous than MLH. However, the prerequisites for the comparison have changed with time and an updated evaluation of MLH was therefore required. In this report, the current knowledge of MLH is summarized with focus on geological prerequisites, methods for boring long, horizontal deposition holes, reinforcement and sealing, deposition and cost. Comparisons with KBS-3 are performed sequentially. An MLH-repository is judged to be more sensitive to ingress of water to the deposition holes during the deposition process. This implies that a MLH repository based on today's knowledge is basically recommended for bedrock with fairly low water baring capacity. It has been demonstrated that MLH has considerable economic potential compared to KBS-3. However, the method is judged to be more technically immature than KBS-3. Particularly, methods and equipment for deposition of canisters need to be developed further. Methods and equipment for deposition can be developed, which fulfill the demands on function and safety, in the near future. MLH cannot therefore be rejected as deposition method

Fetal ECG extraction using independent component analysis by Jade approach

Science.gov (United States)

Giraldo-Guzmán, Jader; Contreras-Ortiz, Sonia H.; Lasprilla, Gloria Isabel Bautista; Kotas, Marian

2017-11-01

Fetal ECG monitoring is a useful method to assess the fetus health and detect abnormal conditions. In this paper we propose an approach to extract fetal ECG from abdomen and chest signals using independent component analysis based on the joint approximate diagonalization of eigenmatrices approach. The JADE approach avoids redundancy, what reduces matrix dimension and computational costs. Signals were filtered with a high pass filter to eliminate low frequency noise. Several levels of decomposition were tested until the fetal ECG was recognized in one of the separated sources output. The proposed method shows fast and good performance.

jade: An End-To-End Data Transfer and Catalog Tool

Science.gov (United States)

Meade, P.

2017-10-01

The IceCube Neutrino Observatory is a cubic kilometer neutrino telescope located at the Geographic South Pole. IceCube collects 1 TB of data every day. An online filtering farm processes this data in real time and selects 10% to be sent via satellite to the main data center at the University of Wisconsin-Madison. IceCube has two year-round on-site operators. New operators are hired every year, due to the hard conditions of wintering at the South Pole. These operators are tasked with the daily operations of running a complex detector in serious isolation conditions. One of the systems they operate is the data archiving and transfer system. Due to these challenging operational conditions, the data archive and transfer system must above all be simple and robust. It must also share the limited resource of satellite bandwidth, and collect and preserve useful metadata. The original data archive and transfer software for IceCube was written in 2005. After running in production for several years, the decision was taken to fully rewrite it, in order to address a number of structural drawbacks. The new data archive and transfer software (JADE2) has been in production for several months providing improved performance and resiliency. One of the main goals for JADE2 is to provide a unified system that handles the IceCube data end-to-end: from collection at the South Pole, all the way to long-term archive and preservation in dedicated repositories at the North. In this contribution, we describe our experiences and lessons learned from developing and operating the data archive and transfer software for a particle physics experiment in extreme operational conditions like IceCube.

Archaeological jade mystery solved using a 119-year-old rock collection specimen

Science.gov (United States)

Harlow, G. E.; Davies, H. L.; Summerhayes, G. R.; Matisoo-Smith, E.

2012-12-01

In a recent publication (Harlow et al. 2012), a ~3200-year old small stone artefact from an archaeological excavation on Emirau Island, Bismarck Archipelago, Papua New Guinea was described and determined to be a piece of jadeite jade (jadeitite). True jadeitite from any part of New Guinea was not previously known, either in an archaeological or geological context, so this object was of considerable interest with respect to its geological source and what that would mean about trade between this source and Emirau Island. Fortuitously, the artefact, presumably a wood-carving gouge, is very unusual with respect to both pyroxene composition and minor mineral constituents. Pyroxene compositions lie essentially along the jadeite-aegirine join: Jd94Ae6 to Jd63Ae36, and without any coexisting omphacite. This contrasts with Jd-Di or Jd-Aug compositional trends commonly observed in jadeitites worldwide. Paragonite and albite occur in veins and cavities with minor titanite, epidote-allanite, and zircon, an assemblage seen in a few jadeitites. Surprisingly, some titanite contains up to 6 wt% Nb2O5 with only trace Ta and a single grain of a Y-Nb phase (interpreted as fergusonite) is present; these are unique for jadeitite. In a historical tribute to C.E.A. Wichmann, a German geologist who taught at Utrecht University, the Netherlands, a previously unpublished description of chlormelanite from the Torare River in extreme northeast Papua, Indonesia was given. The bulk composition essentially matches the pyroxene composition of the jade, so this sample was hypothesized as coming from the source. We were able to arrange a loan from the petrology collection at Utrecht University of the specimen acquired by Wichmann in 1893. In addition we borrowed stone axes from the Natural History Museum - Naturalis in Leiden obtained from natives near what is now Jayapura in eastern-most Papua. Petrography and microprobe analysis of sections of these samples clearly show that (1) Wichmann's 1893

Fluoro-Jade and TUNEL staining as useful tools to identify ischemic brain damage following moderate extradural compression of sensorimotor cortex.

Science.gov (United States)

Kundrotiene, Jurgita; Wägner, Anna; Liljequist, Sture

2004-01-01

Cerebral ischemia was produced by moderate compression for 30 min of a specific brain area in the sensorimotor cortex of Sprague-Dawley rats. On day 1, that is 24 h after the transient sensorimotor compression, ischemia-exposed animals displayed a marked focal neurological deficit documented as impaired beam walking performance. This functional disturbance was mainly due to contralateral fore- and hind-limb paresis. As assessed by daily beam walking tests it was shown that there was a spontaneous recovery of motor functions over a period of five to seven days after the ischemic event. Using histopathological analysis (Nissl staining) we have previously reported that the present experimental paradigm does not produce pannecrosis (tissue cavitation) despite the highly reproducible focal neurological deficit. We now show how staining with fluorescent markers for neuronal death, that is Fluoro-Jade and TUNEL, respectively, identifies regional patterns of selective neuronal death. These observations add further support to the working hypothesis that the brain damage caused by cortical compression-induced ischemia consists of scattered, degenerating neurons in specific brain regions. Postsurgical administration of the AMPA receptor specific antagonist, LY326325 (30 mg/kg; i.p., 70 min after compression), not only improved beam walking performance on day 1 to 3, respectively but also significantly reduced the number of Fluoro-Jade stained neurons on day 5. These results suggest that enhanced AMPA/glutamate receptor activity is at least partially responsible for the ischemia-produced brain damage detected by the fluorescent marker Fluoro-Jade.

Project JADE. Long-term function and safety. Comparison of repository systems

International Nuclear Information System (INIS)

Birgersson, Lars; Pers, K.; Wiborgh, M.

2001-12-01

A comparison of the KBS-3 V(ertical deposition), KBS-3 H(orizontal deposition) and MLH repository systems with regard to the long-term repository performance and the radionuclide migration is presented in the report. Several differences between the repository systems have been identified. The differences are mainly related to the: distance between canister and backfilled tunnels, excavated rock volumes, deposition hole direction. The overall conclusion is that the differences are in general quite small with regard to the repository function and safety. None of the differences are of such importance for the long-term repository performance and radionuclide migration that they discriminate any of the repository systems. The differences between the two KBS-3 systems are small. Based on this study, there is no reason to change from the reference system KBS-3 V to KBS-3 H. MLH has the potential to be a very robust system, especially in a long-term perspective. However, the MLH system will require extensive research, development, and analysis before it will be as confident as the reference repository system, KBS-3 V. Although the MLH and KBS-3 H systems are in some ways favourable compared to the reference system KBS-3 V, the overall conclusion is that the KBS-3 V system is still a very attractive system. A major advantage with KBS-3 V is that it is by far the most investigated and developed system. The JADE-project was initiated in 1996, and the main part of the study was carried out during 1997 and 1998. The JADE study is consequently based on presumptions that were valid a few years ago. Some of these presumptions have been modified since then. The new presumptions are however not judged to change the overall conclusions

Evolution of Diabetes Care in Hong Kong: From the Hong Kong Diabetes Register to JADE-PEARL Program to RAMP and PEP Program

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Ivy H.Y. Ng

2018-03-01

Full Text Available The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This “double phenotype” as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality. The experience from Hong Kong had demonstrated that a multifaceted approach, involving team-based integrated care, information technological advances, and patient empowerment programs were able to reduce the incidence of diabetic complications, hospitalizations, and mortality. System change and public policies to enhance implementation of such programs may provide solutions to combat the burgeoning health problem of diabetes at a societal level.

Element enrichment and U-series isotopic characteristics of the hydrothermal sulfides at Jade site in the Okinawa Trough

Institute of Scientific and Technical Information of China (English)

无

2009-01-01

The geochemical and U-series isotopic characteristics of hydrothermal sulfide samples from the Jade site (127°04.5′E, 27°15′N, water depth 1300-1450 m) at Jade site in the Okinawa Trough were analyzed. In the hydrothermal sulfide samples bearing sulfate (samples HOK1 and HOK2), the LREEs are relatively enriched. All the hydrothermal sulfide samples except HOK1 belong to Zn-rich hydrothermal sulfide. In comparison with Zn-rich hydrothermal sulfides from other fields, the contents of Zn, Pb, Ag, Cd, Au and Hg are higher, the contents of Fe, Al, Cr, Co, Ni, Sr, Te, Cs, Ti and U lower, and the 210Pb radioactivity ratios and 210Pb/Pb ratios very low. In the hydrothermal sulfide mainly composed of sphalerite, the correlations between rare elements Hf and U, and Hf and Mn as well as that between dispersive elements Ga and Zn, are strongly positive; also the contents of Au and Ag are related to Fe-sulfide, because the low temperature promotes enrichment of Au and Ag. Meanwhile, the positive correlations between Fe and Bi and between Zn and Cd are not affected by the change of mineral assemblage. Based on the 210Pb/Pb ratios of hydrothermal sulfide samples (3.99×10-5-5.42×10?5), their U isotopic composition (238U content 1.15-2.53 ppm, 238U activity 1.07-1.87 dpm/g, 234U activity 1.15-2.09 dpm/g and 234U/238U ratio 1.07-1.14) and their 232Th and 230Th contents are at base level, and the chronological age of hydrothermal sulfide at Jade site in the Okinawa Trough is between 200 and 2000 yr.

Radiographic evaluation of the diabetic foot

International Nuclear Information System (INIS)

Jacobs, A.M.

1989-01-01

Radiographic evaluation of the foot in the patient with diabetes mellitus is discussed in this paper. According to the author, it can only be of value when the soft tissue and bony and joint pathologic conditions, which occur more frequently in the diabetic patient are also considered and understood. Although not pathognomic for diabetes mellitus, neuroarthopathy, osteomyelitis, soft tissue infection, and some rheumatic disorders are present with greater frequency in diabetic populations than in non-diabetic populations. Frequently, edema, erythema, hyperthermia, and tenderness are present as nonspecific clinical findings, in which case radiographic evaluation is called upon to define the specific etiology of a particular patient's pathology. Unfortunately, many radiographic, computerized tomographic, and radionuclide studies demonstrate less than optimal positive and negative predictive values unless interpreted in view of clinical history and examination and integrated with the results of other laboratory data. Radiographic evaluation of the diabetic foot may be utilized to establish the presence of disease, the extent of pedal involvement, and the response to therapy. The establishment of the nature of disease processes from radiographic findings alone, however, may be problematic. The diagnosis of osteomyelitis, for example, rests on the recovery of the offending microorganisms from bone aspiration or culture

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

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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.

Diabetes classification using a redundancy reduction preprocessor

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Áurea Celeste Ribeiro

Full Text Available Introduction Diabetes patients can benefit significantly from early diagnosis. Thus, accurate automated screening is becoming increasingly important due to the wide spread of that disease. Previous studies in automated screening have found a maximum accuracy of 92.6%. Methods This work proposes a classification methodology based on efficient coding of the input data, which is carried out by decreasing input data redundancy using well-known ICA algorithms, such as FastICA, JADE and INFOMAX. The classifier used in the task to discriminate diabetics from non-diaibetics is the one class support vector machine. Classification tests were performed using noninvasive and invasive indicators. Results The results suggest that redundancy reduction increases one-class support vector machine performance when discriminating between diabetics and nondiabetics up to an accuracy of 98.47% while using all indicators. By using only noninvasive indicators, an accuracy of 98.28% was obtained. Conclusion The ICA feature extraction improves the performance of the classifier in the data set because it reduces the statistical dependence of the collected data, which increases the ability of the classifier to find accurate class boundaries.

Altitudinal patterns of plant diversity on the Jade Dragon Snow Mountain, southwestern China.

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Xu, Xiang; Zhang, Huayong; Tian, Wang; Zeng, Xiaoqiang; Huang, Hai

2016-01-01

Understanding altitudinal patterns of biological diversity and their underlying mechanisms is critically important for biodiversity conservation in mountainous regions. The contribution of area to plant diversity patterns is widely acknowledged and may mask the effects of other determinant factors. In this context, it is important to examine altitudinal patterns of corrected taxon richness by eliminating the area effect. Here we adopt two methods to correct observed taxon richness: a power-law relationship between richness and area, hereafter "method 1"; and richness counted in equal-area altitudinal bands, hereafter "method 2". We compare these two methods on the Jade Dragon Snow Mountain, which is the nearest large-scale altitudinal gradient to the Equator in the Northern Hemisphere. We find that seed plant species richness, genus richness, family richness, and species richness of trees, shrubs, herbs and Groups I-III (species with elevational range size 500 m, respectively) display distinct hump-shaped patterns along the equal-elevation altitudinal gradient. The corrected taxon richness based on method 2 (TRcor2) also shows hump-shaped patterns for all plant groups, while the one based on method 1 (TRcor1) does not. As for the abiotic factors influencing the patterns, mean annual temperature, mean annual precipitation, and mid-domain effect explain a larger part of the variation in TRcor2 than in TRcor1. In conclusion, for biodiversity patterns on the Jade Dragon Snow Mountain, method 2 preserves the significant influences of abiotic factors to the greatest degree while eliminating the area effect. Our results thus reveal that although the classical method 1 has earned more attention and approval in previous research, method 2 can perform better under certain circumstances. We not only confirm the essential contribution of method 1 in community ecology, but also highlight the significant role of method 2 in eliminating the area effect, and call for more

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

DEFF Research Database (Denmark)

Pouwer, F; Snoek, Frank J

2002-01-01

aspects of the quality of diabetes care as delivered by the specialist in internal medicine (internist) and the diabetes nurse specialist (DNS). Two principal components analyses (internist/DNS) both yielded one 14 item factor with a high internal consistency. Satisfaction with diabetes care, fewer......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...... variables, HbA1c, number of diabetes complications, satisfaction with diabetes care, diabetes related distress, and fear of hypoglycaemia were assessed by self-report. In addition, satisfaction with diabetes care and evaluations about quality of the care were measured at 16 month follow up. Statistical...

Evaluation of the diabetes health plan to improve diabetes care and prevention.

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Duru, O Kenrik; Mangione, Carol M; Chan, Charles; Keckhafer, Abigail; Kimbro, Lindsay; Kirvan, K Anya; Turk, Norman; Luchs, Robert; Li, Jinnan; Ettner, Susan

2013-01-01

Investigators from the University of California, Los Angeles (UCLA), and members of the leadership and data analysis teams at UnitedHealthcare (UHC) are partnering to evaluate the Diabetes Health Plan (DHP), an innovative disease-specific insurance product designed by UHC specifically for patients with prediabetes or diabetes. The DHP provides improved access to care management, telephone coaching, and enhanced Internet-based communication with enrollees. The evaluation will use a quasi-experimental design, comparing patients from employer groups that offer the DHP with patients from groups that do not, to determine the effect of the DHP on incidence of diabetes, adherence to metformin, and costs of care among patients with prediabetes. Other factors studied will be cardiovascular risk factor control, adherence to preventive services, health care use, and costs of care among patients with existing diabetes.

Evaluation of Genotoxic and Cytotoxic Effects in Human Peripheral Blood Lymphocytes Exposed In Vitro to Neonicotinoid Insecticides News

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María Elena Calderón-Segura

2012-01-01

Full Text Available Calypso (thiacloprid, Poncho (clothianidin, Gaucho (imidacloprid, and Jade (imidacloprid are commercial neonicotinoid insecticides, a new class of agrochemicals in México. However, genotoxic and cytotoxic studies have not been performed. In the present study, human peripheral blood lymphocytes (PBL were exposed in vitro to different concentrations of the four insecticides. The genotoxic and cytotoxic effects were evaluated using the alkaline comet and trypan blue dye exclusion assays. DNA damage was evaluated using two genotoxicity parameters: tail length and comet frequency. Exposure to 9.5×10-6 to 5.7×10-5 M Jade; 2.8×10-4 to 1.7×10-3 M Gaucho; 0.6×10-1 to 1.4×10-1 M Calypso; 1.2×10-1 to 9.5×10-1 M Poncho for 2 h induced a significant increase DNA damage with a concentration-dependent relationship. Jade was the most genotoxic of the four insecticides studied. Cytotoxicity was observed in cells exposed to 18×10-3 M Jade, 2.0×10-3 M Gaucho, 2.0×10-1 M Calypso, 1.07 M Poncho, and cell death occurred at 30×10-3 M Jade, 3.3×10-3 M Gaucho, 2.8×10-1 M Calypso, and 1.42 M Poncho. This study provides the first report of genotoxic and cytotoxic effects in PBL following in vitro exposure to commercial neonicotinoid insecticides.

Evaluation of diabetes care management in primary clinics based on the guidelines of American Diabetes Association.

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Albarrak, Ahmed Ismail; Mohammed, Rafiuddin; Assery, Bushra; Allam, Dalya; Morit, Sarah Al; Saleh, Reem Al; Zare'a, Reem

2018-01-01

There is a rapid increase in the incidence of diabetes mellitus in Saudi Arabia. Diabetes management is an essential constituent to prevent prognosis of diabetes complications. The main objective of this study was to assess diabetes care in primary clinics based on the guidelines of American Diabetes Association (ADA). A retrospective study at King Khaled University Hospitals, Riyadh, Saudi Arabia. A total of 200 patients were randomly selected from the databases of primary care clinics. An evaluation checklist was created based on the ADA treatment guidelines such as medical history, physical examination, laboratory evaluation, and referrals. The result showed that elements achieving the ADA targets for overall care were medical history (44.9%), physical examination (59.6%), laboratory evaluation (36.3%), and referrals (19.3%). The other subelement indicators such as referral to diabetes self-management education clinics (10%), dental examination (2%), HbA1c regular monitoring (33.5%), and blood pressure determination (100%) were documented with adherence to ADA standards. Diabetes management standards are an essential element in the success of the management plan. Most of the elements examined are not in full compliance with the ADA standard. Continues monitoring and self-review are recommended.

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

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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.

Diabetic Nephropathy : Evaluation with Doppler Ultrasonography

International Nuclear Information System (INIS)

Sim, Jung Suk; Kim, Seung Hyup; Kang, Heung Sik; Park, Jae Hyung; Han, Man Chung

1996-01-01

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

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.

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.

Evaluating the Effect of a Diabetes Health Coach in Individuals with Type 2 Diabetes.

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Sherifali, Diana; Viscardi, Virginia; Bai, Johnny-Wei; Ali, R Muhammad Usman

2016-02-01

Diabetes health coaching has not been adequately assessed in individuals with type 2 diabetes. The objective of this review was to synthesize the evidence of health coaching for individuals with diabetes to determine the effects of coaching on diabetes control, specifically on glycated hemoglobin (A1C) levels. The EMBASE, MEDLINE, CINAHL, PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Reference lists from important publications were also reviewed. At least 2 evaluators independently screened and extracted data from eligible studies. A total of 8 trials met the selection criteria, which included 724 adult participants; 353 participants were randomized to a diabetes health coaching intervention, and 371 were randomized to usual care. The pooled effect of diabetes health coaching overall was a statistically significant reduction of A1C levels by 0.32 (95% CI, -0.50 to -0.15). Longer diabetes health coaching exposure (>6 months) resulted in a 0.57% reduction in A1C levels (95% CI, -0.76 to -0.38), compared to shorter diabetes health coaching exposure (≤6 months) (-0.23%; 95% CI, -0.37 to -0.09). Across all studies, diabetes health coaching consisted of goal setting, knowledge acquisition, individualized care and frequent follow up. Diabetes health coaching has an emerging role in healthcare that facilitates self-care, behaviour change and offers frequent follow up and support. This review finds that health coaching for those with diabetes is an effective intervention for improving glycemic control, which may be of greater benefit when offered in addition to existing diabetes care. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Tests of perturbative and non perturbative structure of moments of hadronic event shapes using experiments JADE and OPAL; Untersuchung perturbativer und nichtperturbativer Struktur der Momente hadronischer Ereignisformvariablen mit den Experimenten JADE und OPAL

Energy Technology Data Exchange (ETDEWEB)

Pahl, Christoph Johannes

2008-01-29

In hadron production data of the e{sup +}e{sup -} annihilation experiments JADE and OPAL we measure the first five moments of twelve hadronic-event-shape variables at c.m. energies from 14 to 207 GeV. From the comparison of the QCD NLO prediction with the data corrected by means of MC models about hadronization we obtain the reference value of the strong coupling {alpha}{sub s}(M{sub Z{sup 0}})=0.1254{+-}0.0007(stat.){+-}0.0010(exp.){sup +0.0009}{sub -0.0023}(had.){sup +0.0069}{sub -0.0053}(theo.). For some, especially higher moments, systematic unsufficiencies in the QCD NLO prediction are recognizable. Simultaneous fits to two moments under assumption of identical renormalization scales yield scale values from x{sub {mu}}=0.057 to x{sub {mu}}=0.196. We check predictions of different non-perturbative models. From the single-dressed-gluon approximation a perturbative prediction in O({alpha}{sup 5}{sub s}) results with neglegible energy power correction, which describes the thrust average on hadron level well with {alpha}{sub s}(M{sub Z{sup 0}})=0.1186{+-}0,0017(exp.){sub -0.0028}{sup +0.0033}(theo.). The variance of the event-shape variable is measured and compared with models as well as predictions. [German] In Hadronproduktionsdaten der e{sup +}e{sup -}-Vernichtungsexperimente JADE und OPAL messen wir die ersten fuenf Momente von zwoelf hadronischen Ereignisformvariablen bei Schwerpunktsenergien von 14 bis 207 GeV. Aus dem Vergleich der QCD NLO-Vorhersage mit den mittels MC-Modellen um Hadronisierung korrigierten Daten erhalten wir den Referenzwert der starken Kopplung {alpha}{sub s}(M{sub Z{sup 0}})=0.1254{+-}0.0007(stat.){+-}0.0010(exp.){sup +0.0009}{sub -0.0023}(had.){sup +0.0069}{sub -0.0053}(theo.). Fuer einige, insbesondere hoehere, Momente sind systematische Unzulaenglichkeiten in der QCD NLO-Vorhersage erkenntlich. Simultane Fits an zwei Momente unter Annahme identischer Renormierungsskalen ergeben Skalenwerte von x{sub {mu}}=0.057 bis x{sub {mu}}=0

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)

Evaluation of a diabetes nurse specialist prescribing project.

Science.gov (United States)

Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery

2014-08-01

To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care

EVALUATION OF DRY EYES IN DIABETES MELLITUS

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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.

Comparative Anti-Diabetic Evaluation of Different Parts of Himalrandia tetrasperma in Alloxan Induced Diabetic in Mice

International Nuclear Information System (INIS)

Ajaib, M.

2016-01-01

The present experiments were designed to investigate the acute effects of methanolic extracts of various parts of H. tetrasperma in diabetic mice. The basic phyto-chemical study showed the occurrence of alkaloids, saponins, flavonoids and tannins as main phyto-constituents in the methanolic extract. Diabetes was induced experimentally in mice by intra peritoneally injecting alloxan (150 mg/kg i.p.). In acute study, methanolic H. tetrasperma extracts of various parts of plant were evaluated for anti-diabetic potential in alloxan induced diabetic mice. Extracts of leaves, bark and seeds (250 mg/kg, i.p) and metformin (250 mg/kg i.p) were given intra peritoneal in alloxan treated diabetic mice and blood glucose levels were measured at 0, 360 and 24 h. There was significant lowering of blood glucose level at 1 h after treatment, in diabetic mice treated with methanolic extracts of bark (182.3 ± 3.6 mg/dL), leaves (178.5 ± 1.2 mg/dL) and seeds (156.3 ± 11.3 mg/dL) when compared with control diabetic group (280 ± 7.92 mg/dL). Highly significant results were also obtained at 24 h after treatment with methanolic extracts of bark (187.67 ±1.2 mg/dL), leaves (170.66 ± 2.3 mg/dL) and seeds (142 ± 8.7 mg/dL) when compared with control diabetic group (257.7 ± 6.7 mg/dL). It is concluded that methanolic extract of all parts possess significant anti-diabetic activity which is due to the presence of phytochemicals, i.e. alkaloids, flavonoids, phenols, saponins, tannins and it can be further evaluated for the mechanism involved. (author)

Jade: using on-demand cloud analysis to give scientists back their flow

Science.gov (United States)

Robinson, N.; Tomlinson, J.; Hilson, A. J.; Arribas, A.; Powell, T.

2017-12-01

The UK's Met Office generates 400 TB weather and climate data every day by running physical models on its Top 20 supercomputer. As data volumes explode, there is a danger that analysis workflows become dominated by watching progress bars, and not thinking about science. We have been researching how we can use distributed computing to allow analysts to process these large volumes of high velocity data in a way that's easy, effective and cheap.Our prototype analysis stack, Jade, tries to encapsulate this. Functionality includes: An under-the-hood Dask engine which parallelises and distributes computations, without the need to retrain analysts Hybrid compute clusters (AWS, Alibaba, and local compute) comprising many thousands of cores Clusters which autoscale up/down in response to calculation load using Kubernetes, and balances the cluster across providers based on the current price of compute Lazy data access from cloud storage via containerised OpenDAP This technology stack allows us to perform calculations many orders of magnitude faster than is possible on local workstations. It is also possible to outperform dedicated local compute clusters, as cloud compute can, in principle, scale to much larger scales. The use of ephemeral compute resources also makes this implementation cost efficient.

Fluoro jade-C staining in the assessment of brain injury after deep hypothermia circulatory arrest.

Science.gov (United States)

Wang, Ren; Ma, Wei-Guo; Gao, Guo-Dong; Mao, Qun-Xia; Zheng, Jun; Sun, Li-Zhong; Liu, Ying-Long

2011-02-04

To evaluate the efficacy of Fluoro Jade-C staining (FJC) in the assessment of brain injury after deep hypothermia circulatory arrest (DHCA). Six healthy adult miniature male pigs underwent DHCA, the rectal temperature was down to 18°C, circulation was stopped , circulatory arrest was maintained for 60 minutes. On postoperative day 1, perfusion-fixation was performed on brain tissue. Cerebral cortex, hippocampus, cerebellum were taken for sampling. FJC, hematoxylin-eosin staining (HE), nissl staining (NISSL), terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) were performed to detect the histological and pathological changes. Histological scores of all slices were ranked. Comparison between the FJC and other techniques was done by analysis of variance (ANOVA) according to histological scores. All animals survived the operation. On the cerebral cortex, in comparison of FJC between HE, NISSL and TUNEL, the p value was 0.90, 0.40, 0.16 respectively (p>0.05). On the hippocampus, the comparison of FJC with HE, NISSL and TUNEL had a p value of 0.12, 0.23, 0.62 respectively (p>0.05). On the cerebellum, in comparing FJC with HE, NISSL and TUNEL, the p value was 0.96, 0.77, 0.96 respectively (p>0.05). On representative regions, the results of FJC were in accordance with that of TUNEL, NISSL and HE. Furthermore, ascertainment of brain injury is easier with FJC. FJC is a reliable and convenient method to assess brain injury after DHCA. Copyright © 2010 Elsevier B.V. All rights reserved.

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 pgood metabolic control (pgood and bad metabolic control (pgood 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.

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

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)

Computer vision algorithm for diabetic foot injury identification and evaluation

International Nuclear Information System (INIS)

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.

2016-10-01

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)

Transformación del Q-Learning para el Aprendizaje en Agentes JADE

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Nayma Cepero-Pérez

2015-06-01

Full Text Available El aumento de la interacción entre los sistemas informáticos ha modificado la forma tradicional de analizarlos y desarrollarlos. La necesidad de la interacción entre los componentes del sistema es cada vez más importante para poder resolver tareas conjuntas, que de forma individual serían muy costosas o incluso imposibles de desarrollar. Los sistemas multi-agente ofrecen una arquitectura interesante y completa para ejecutar tareas distribuidas que cooperan entre sí. La creación de un sistema multi-agente o un agente requiere de gran esfuerzo por lo que se han adoptado métodos como los patrones de implementación. El patrón Proactive Obsever_JADE permite crear los agentes e incluirle en cada uno comportamientos dotados de inteligencia que pueden evolucionar utilizando técnicas de aprendizaje automático. El aprendizaje por refuerzo es una técnica del aprendizaje automático que permite a los agentes aprender a través de interacciones de prueba y error, en un ambiente dinámico. El aprendizaje por refuerzo en sistemas multi-agente ofrece nuevos retos derivados de la distribución del aprendizaje, como pueden ser la necesidad de la coordinación entre agentes o la distribución del conocimiento, que deben ser analizados y tratados.

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.

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.

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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.

Untersuchung perturbativer und nichtperturbativer Struktur der Momente hadronischer Ereignisformvariablen mit den Experimenten JADE und OPAL

CERN Document Server

Pahl, Christoph Johannes

2007-01-01

In Hadronproduktionsdaten der e+e− - Vernichtungsexperimente JADE und OPAL messen wir die ersten f¨unf Momente von zw¨olf hadronischen Ereignisformvariablen bei Schwerpunktsenergien von 14 bis 207GeV. Aus dem Vergleich der QCD NLO-Vorhersage mit den mittels MC-Modellen um Hadronisierung korrigierten Daten erhalten wir den Referenzwert der starken Kopplung αs(MZ0) = 0.1254 ± 0.0007(stat.) ± 0.0010(exp.)+0.0009 −0.0023(had.)+0.0069 −0.0053(theo.) . F¨ur einige, insbesondere h¨ohere, Momente sind systematische Unzul¨anglichkeiten in der QCD NLO-Vorhersage erkenntlich. Simultane Fits an zwei Momente unter Annahme identischer Renormierungsskalen ergeben Skalenwerte von xμ=0.057 bis xμ=0.196 . Wir pr¨ufen Vorhersagen verschiedener nichtperturbativer Modelle. Aus der Single Dressed Gluon - N¨aherung ergibt sich eine perturbative Vorhersage in O(α5 s ) mit zu vernachl¨assigender Energiepotenzkorrektur, die den Mittelwert von Thrust auf Hadronniveau gut beschreibt mit αs(MZ0) = 0.1186 ± 0.0007(st...

THE EVALUATION OF PHYSICAL ACTIVITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

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Vladan Jovanović

2003-10-01

Full Text Available It is already known that physical activity is very important measure in treatment of type 2 diabetes mellitus, but in spite of that, in our country, there is neither its adequate use in therapy, nor the evaluation of its level in type 2 diabetics.The aim of this study is to evaluate the level of physical activity in patients with type 2 diabetes, by using the questionnaire for evaluation of physical activity, based on the International Physical Activity Questionnaire used in the Framingham Heart Study.The level of physical activity is evaluated by the Physical Activity Index (PAI, which is calculated by summing the number of hours spent in each activity intensity level (vigorous, moderate, light physical activity, sedentary behavior and sleep and multiplying by a respective weight factor, derived from the estimated oxygen consumption requirement for each intensity level (Metabolic Equivalent, MET. The results were compared to the results of healthy control subjects.The estimated value of PAI in patients with type 2 diabetes was 34.1 ± 6.4 and in controls 37.6 ± 6.4. The energy expenditure in the subgroup of patients with type 2 diabetes with predominantly sedentary behavior was 852 kcal minor than in the control group.The results of this investigation show very low level of physical activity in patients with type 2 diabetes and its correlation with coronary risk factors

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

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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.

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.

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

Description Diabetes and glucose intolerance are common complications of chronic pancreatitis, yet clinical guidance on their detection, classification, and management is lacking. Methods A working group reviewed the medical problems, diagnostic methods, and treatment options for chronic pancreatitis-associated diabetes for a consensus meeting at PancreasFest 2012. Results 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 gram 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. Conclusions Physicians should evaluate and treat glucose intolerance in patients with pancreatitis. PMID:23890130

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

OpenAIRE

Ghasem Shokri; Hamed Fathi; Majid Jafari Sabet; Nafiseh Nasri Nasrabadi; Ramin Ataee

2015-01-01

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 (ST...

Evaluation and Prevention of Diabetic Neuropathy

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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.

Diseño de un sistema multi-agente para monitoreo de redes utilizando JADE y JPCAP

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Alexis De la Hoz Manotas

2010-01-01

Full Text Available La programación orientada a agentes es un paradigma que ha tomado especial dedicación en los últimos años, en especial en investigaciones, desde sistemas de supervisión y control de redes de computadores, simulación de procesos industriales, recopilación de información, sistemas de oferta y demanda, etc. El diseño de un sistema multiagente (MAS requiere esfuerzos diferentes a los encontrados en un desarrollo de software tradicional, diversas estrategias como BDI, GAIA y MESSAGE pueden ser utilizadas como modelo teórico para tal fin, mas sin embargo, con los avances en la inteligencia artificial, los agentes inteligentes están ahora en capacidad de demostrar mucha mayor autonomía y aprendizaje que hasta ahora. Se ha desarrollado un primer intento en esbozar lo que sería el diseño de un sistema multiagente para la monitorización de redes, escogiendo como plataforma de desarrollo a JADE y Jpcap como herramientas de captura.

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.

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

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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.

Evaluation of the impact of a diabetes education eLearning program for school personnel on diabetes knowledge, knowledge retention and confidence in caring for students with diabetes.

Science.gov (United States)

Taha, Nehad A; Rahme, Zahra; Mesbah, Naglaa; Mahmoud, Fatma; AlKandari, Sarah; Othman, Nashwa; Sharaikha, Hanan; Lari, Bashayer S; AlBeloushi, Shaima; Saad, Eglal; Arefanian, Hossein; Sukkar, Faten F

2018-05-01

To study the impact of a novel comprehensive eLearning approach in delivering diabetes related education program that includes knowledge and sets of practices to the school personnel in Kuwait to enable them to provide a supportive environment for students with diabetes. The program was designed with three components namely; knowledge, skills and recommendations. The diabetes knowledge was delivered through an interactive eLearning program, the effectiveness of which was assessed using diabetes knowledge questionnaires which were deployed pre- and post-course delivery. Additionally, the participants' knowledge retention and confidence in caring for a student with diabetes were evaluated at 6 or 12 months post-intervention. A total of 124 public schools' personnel participated in the program. Post e-Learning delivery, diabetes knowledge increased significantly from baseline (p eLearning diabetes education for school personnel increases their knowledge which can be retained for up to 12 months and imparts confidence in caring for students with diabetes. This novel approach of delivering diabetes education will help school personnel in managing students with diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

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.

The diabetic foot: Magnetic resonance imaging evaluation

International Nuclear Information System (INIS)

Beltran, J.; Campanini, D.S.; Knight, C.; McCalla, M.

1990-01-01

Fourteen diabetic patients with suspected foot infection and/or neuropathic joint (Charcot Joint) were evaluated with magnetic resonance imaging (MRI) in an attempt to assess the extent of the infection and also to distinguish infection from the changes seen with neuroarthropathy. The majority of patients with infection had more than one site of involvement and the following diagnoses were made by MRI evaluation: Osteomyelitis (n=8), abscess (n=7), neuropathic joint (n=5), septic arthritis (n=4), and tenosynovitis (n=4). Clinical or surgical/pathological confirmation of the MRI diagnoses was obtained in all but nine sites of infection or cases of neuropathic joint. If the two diagnostic categories of septic arthritis and tenosynovitis are excluded, all but four of the MRI diagnoses were confirmed. A distinctive pattern for neuroarthropathy was identified in five cases, consisting of low signal intensity on T1- and T2-weighted images within the bone marrow space adjacent to the involved joint. We conclude that MRI is a valuable adjunct in the evaluation of the diabetic foot, and that it provides accurate information regarding the presence and extent of infection in this subset of patients. MRI has proven particularly helpful in differentiating neuroarthropathy from osteomyelitis. (orig.)

Making death 'good': instructional tales for dying in newspaper accounts of Jade Goody's death.

Science.gov (United States)

Frith, Hannah; Raisborough, Jayne; Klein, Orly

2013-03-01

Facilitating a 'good' death is a central goal for hospices and palliative care organisations. The key features of such a death include an acceptance of death, an open awareness of and communication about death, the settling of practical and interpersonal business, the reduction of suffering and pain, and the enhancement of autonomy, choice and control. Yet deaths are inherently neither good nor bad; they require cultural labour to be 'made over' as good. Drawing on media accounts of the controversial death of UK reality television star Jade Goody, and building on existing analyses of her death, we examine how cultural discourses actively work to construct deaths as good or bad and to position the dying and those witnessing their death as morally accountable. By constructing Goody as bravely breaking social taboos by openly acknowledging death, by contextualising her dying as occurring at the end of a life well lived and by emphasising biographical continuity and agency, newspaper accounts serve to position themselves as educative rather than exploitative, and readers as information-seekers rather than ghoulishly voyeuristic. We argue that popular culture offers moral instruction in dying well which resonates with the messages from palliative care. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

Science.gov (United States)

McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

2016-07-28

Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative

Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) study: Methodology and baseline characteristics of a randomized controlled trial evaluating an occupation-based diabetes management intervention for young adults.

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Pyatak, Elizabeth A; Carandang, Kristine; Vigen, Cheryl; Blanchard, Jeanine; Sequeira, Paola A; Wood, Jamie R; Spruijt-Metz, Donna; Whittemore, Robin; Peters, Anne L

2017-03-01

This paper describes the study protocol used to evaluate the Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) intervention and reports on baseline characteristics of recruited participants. REAL Diabetes is an activity-based intervention designed to address the needs of young adults diagnosed with type 1 (T1D) or type 2 diabetes (T2D) from low socioeconomic status or racial/ethnic minority backgrounds. The REAL intervention incorporates tailored delivery of seven content modules addressing various dimensions of health and well-being as they relate to diabetes, delivered by a licensed occupational therapist. In this pilot randomized controlled trial, participants are assigned to the REAL Diabetes intervention or an attention control condition. The study's primary recruitment strategies included in-person recruitment at diabetes clinics, mass mailings to clinic patients, and social media advertising. Data collection includes baseline and 6-month assessments of primary outcomes, secondary outcomes, and hypothesized mediators of intervention effects, as well as ongoing process evaluation assessment to ensure study protocol adherence and intervention fidelity. At baseline, participants (n=81) were 51% female, 78% Latino, and on average 22.6years old with an average HbA1c of 10.8%. A majority of participants (61.7%) demonstrated clinically significant diabetes distress and 27.2% reported symptoms consistent with major depressive disorder. Compared to participants with T1D, participants with T2D had lower diabetes-related self-efficacy and problem-solving skills. Compared to participants recruited at clinics, participants recruited through other strategies had greater diabetes knowledge but weaker medication adherence. Participants in the REAL study demonstrate clinically significant medical and psychosocial needs. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of cardiac denervation in patients with long-standing diabetes

International Nuclear Information System (INIS)

Khurram, M.; Khar, Hamama-tul-Bushra; Malik, M.F. Fazal-ur-Rehman; Javed, S.; Hassan, Z.; Minhas, Z.; Goraya, M.F.; Shakoor, A.

2002-01-01

Objective: Evaluation of cardiac autonomic dysfunction in long-standing diabetics, comparing patients treated with insulin and oral hypo glycemic agents. Design: Observational and comparative study between two treatment groups. Place and Duration of Study: At department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, for 6 months. Subjects and Methods: Fifty diabetic patients of about 10 years illness were studied. Patients were divided into two groups, Group 1(13 males, 12 females; mean age 33.08 years) included those who received insulin, and Group II patients (12 males, 13 females; mean age 54.68 years) who received oral hypo glycemic agents for their diabetic illness. Evaluation of cardiac denervation in both the groups was done in terms of presence of resting tachycardia, loss of sinus arrhythmia and abnormalities of Valsava response. Results: At least some form of cardiac denervation was present in 62% of total subjects. 48% of Group I and 76 % of Group II patients. A significantly high number of patients treated with oral hypo glycemic agents had evidence of cardiac denervation when compared with patients who were treated with insulin (p < 0.05). Conclusion: Cardiac denervation is common in long-standing diabetics specifically in those treated with oral hypo glycemic agents. (author)

Evaluation of an Ongoing Diabetes Group Medical Visit in a Family Medicine Practice.

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Cunningham, Amy T; Delgado, David J; Jackson, Joseph D; Crawford, Albert G; Jabbour, Serge; Lieberthal, Robert D; Diaz, Victor; LaNoue, Marianna

2018-01-01

Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes. GMV participants (n = 230) attended an average of 1 session. Participants did not differ significantly from the matched comparison group (n = 230) on clinical, process of care or utilization outcomes. The diabetes GMV was not associated with improvements in outcomes. Further studies should examine diabetes GMV implementation challenges to enhance their effectiveness in everyday practice. © Copyright 2018 by the American Board of Family Medicine.

TO EVALUATE PREVALENCE OF DIABETES AND HIV IN NEWLY-DIAGNOSED MULTIDRUGRESISTANT TUBERCULOSIS PATIENTS ADMITTED FOR PRETREATMENT EVALUATION IN DOTS PLUS CENTRE, THANJAVUR

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Namasivayam Kuppusamy

2017-07-01

Full Text Available BACKGROUND More than 9 million people fall sick with tuberculosis every year in the world. People with weak immune system as a result of disease like diabetes and HIV are at high risk of developing MDR-TB infection. Proper monitoring and evaluation are needed to control MDR-TB in HIV and diabetes patients. The aim of the study is to find the prevalence of diabetes and HIV among MDR-TB patients admitted for pretreatment evaluation in Dots Plus Centre, Thanjavur Medical College, Tamilnadu. MATERIALS AND METHODS The medical records with datas of 96 patients with MDR-TB who are having diabetes and HIV infection were examined. These cases were diagnosed and registered during January 2015 to December 2015. These patients had drug resistant to first line antituberculosis drugs (isoniazid and rifampicin. Duration of diabetes and HIV infection were noted. Age were categorised in to four groups- 20-29 years, 30-39 years, 40-49 years and above 50 years. The potential risk of association of diabetes, HIV or both with MDR-TB was evaluated by univariate conditional logistic regression model. RESULTS Out of 96 newly-diagnosed MDR-TB patients, prevalence of diabetes is about 34.37%, out of which (84.84% were males and (15.15% were females. Out of 34.37%, 38.54% of patients had controlled diabetes, 61.45% patients had uncontrolled diabetes. Nearly, more than half of diabetes patient falls under uncontrolled diabetes. More number of male patients had diabetes with MDR-TB when compared to females. 10.4% of these persons got oral hypoglycaemic agent and 6.3% got insulin as treatment for diabetes. 1% had irregular treatment with poor compliance. Prevalence of HIV is about 4.16% out of which 75% were males and 25% were females. One patient had both diabetes and HIV with MDR tuberculosis. CONCLUSION In our retrospective study, prevalence of diabetes in MDR-TB patients were more common in males than in females, most of them were in the age groups of 40 years and above

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

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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).

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

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Sibbald, R. Gary; Martin, Carlos

2015-01-01

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 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. PMID:26089901

EVALUATION OF PRE AND POST TRAINING PRACTICES REGARDING MANAGEMENT OF DIABETES

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M Mohanty

1995-09-01

Full Text Available The study was conducted on 112 diabetic patients in S.S. Hospital.Varanasi to evaluate the pre- and post- training practices regarding management of Diabetes mellitus. A pre-tested structured respondent schedule urn used to collect information regarding the socio-economic status and some of the managerial aspects of the disease by questionaire cum interview method. Education cum training was imparted to all the respondents in the first three months and in the fourth month evaluation programme was carried out and their level ofpractive regarding different aspects of diabetic management were assessed by using seven point score method. It was found that training was proved effective for the aspect "Physical exer­cise" and "Restricted diet" but slight improvement in the practive score was seen in "Precaution in Special Hygienic Condition" aspects. So. con­tinuous education programme was needed to improve their practice rate.

Evaluation of Salivary Profile among Adult Type 2 Diabetes Mellitus Patients in South India.

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K M, Prathibha; Johnson, Priscilla; Ganesh, Mathangi; Subhashini, Arcot S

2013-08-01

A lack of consensus on the possible association between diabetes and salivary dysfunction motivated us to conduct this investigation on the salivary parameters in diabetic and non diabetic subjects. This could also make the use of saliva as an alternative to that of blood in the diagnosis/monitoring of diabetes mellitus. To compare the salivary flow rates and the salivary physical and biochemical parameters of diabetic (D) and non diabetic (ND) subjects. The participants in this study included 30 non diabetic subjects and 30 diabetic volunteers who had Type 2 Diabetes mellitus for a minimum of 2 years. Unstimulated whole saliva was collected in the fasting state. Salivary pH, flow rate and organic and inorganic constituents were evaluated. Data which was collected was statistically analysed and interpreted. Salivary pH (ND=7.09±0.29, D=6.69±0.35), flow rate (ND=0.67±0.07, D=0.46±0.02) and salivary amylase (ND=92.51±13.74, D=19.20±1.8) were significantly lower in diabetics. They had significantly higher levels of salivary glucose (ND=4.33 ± 0.29, D=17.31±2.05), total proteins (ND=424.46±237.34, D=877.29±603.84), sodium (ND=4.31±0.65, D=14.42±1.83) and potassium (ND=20.84±0.71, D=25.95±1.56) and lower levels of calcium (ND=6.39±0.5, D=4.22±0.12) in comparison to those in the non-diabetic group. Significant variations were observed in salivary physical and biochemical parameters between diabetics and non diabetics. Evaluation of salivary parameters can be a cost effective and a non invasive alternative for screening, diagnosis and monitoring of diabetes, to blood.

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

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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.

Simplifying the Evaluation of Children With New Onset Diabetes: Utility of Pancreatic Autoantibodies for Diabetes Type Classification and Use of Serum Bicarbonate to Diagnose and Classify Diabetic Ketoacidosis.

OpenAIRE

Von Oettingen, Julia Elisabeth

2015-01-01

Objectives: To assess whether routinely measuring pancreatic autoantibodies (PAA) in pediatric new onset diabetes (NODM) is necessary, and to evaluate serum bicarbonate (HCO3) as a substitute for venous pH (vpH) in the diagnosis of diabetic ketoacidosis (DKA). Methods: Retrospective analysis of all patients with NODM admitted to Boston Children's Hospital from 10/1/07-7/1/13. Logistic regression was used to develop a clinical score to classify diabetes type. Linear and logistic regression...

Evaluation of Anticonvulsive ٍEffect of Magnesium Oxide Nanoparticles in Comparison with Conventional MgO in Diabetic and Non-diabetic Male Mice

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Leila Jahangiri

2014-05-01

Full Text Available Introduction: Some studies show magnesium has anticonvulsive effect in some animal models. Despite of the availability of well-studied anticonvulsant drugs, this evaluation was not carried on new kind of magnesium supplement, magnesium oxide nanoparticles (nMgO. According to the interaction between magnesium and convulsion, this study was designed to evaluate the effect of nMgO on strychnine-induced convulsive model in compared to its conventional in diabetic and normal mice. Methods: Healthy male albino mice were divided to 10 groups. Diabete mellitus was induced by streptozocin in 5 groups. Conventional and nanoparticle MgO (5&10mg/kg in presence and absence diabetes injected to mice, then strychnine injected and onset of convulsions and time of death were measured after strychnine administration. Results: Convulsive parameters did not change in normal and diabetic mice. cMgO pretreatment did not have anticonvulsant effect in strychnine-induced convulsion in normal and diabetic mice. But nMgO significantly changed convulsion onset and death time after strychnine administration in normal and diabetic status. Discussion: According to our results It seems that nMgO may be important in prevention or treatment of epilepsy and has more efficacy than its conventional form to showing anticonvulsive effect that probably is related to the physicochemical properties of nMgO, specially in diabetic subjects, a point that need to further investigation.

Diabetic muscle infarction: radiologic evaluation

International Nuclear Information System (INIS)

Chason, D.P.; Fleckenstein, J.L.; Burns, D.K.; Rojas, G.

1996-01-01

Four patients with severe diabetes mellitus presenting with acute thigh pain, tenderness, and swelling were evaluated by imaging techniques and biopsy. Edema in the affected muscles was seen in two patients with MRI studies. Femoral artery calcification and mild muscle swelling was present in one patient who underwent CT. Decreased echogenicity was seen in the involved muscle in a patient studied with ultrasound. Serum enzymes were normal or mildly elevated in three patients (not reported in one). Biopsy demonstrated necrosis and regenerative change in all cases. MRI, although nonspecific, is the best imaging technique to suggest the diagnosis of DMI in the appropriate clinical setting, thereby obviating biopsy. (orig./MG)

Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

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Amin, Noha; Doupis, John

2016-01-01

The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

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

Science.gov (United States)

2013-08-05

... efforts to improve diabetes-related health care and education, as well as systems for delivering care; (6... Comment Request: Community Evaluation of the National Diabetes Education Program's Diabetes HealthSense... information technology. To Submit Comments and For Further Information: To obtain a copy of the data...

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

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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

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

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Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

2009-05-09

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. 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. 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. Protocol NCT00325624.

Radionuclide evaluation of the liver in diabetes

International Nuclear Information System (INIS)

Abdel-Razzak, M.; El-Ashmawy, A.

1982-01-01

Hepatic involvement in diabetes has been previously demonstrated in experimental animals and in patients by clinical examination as well as by autopsy. The aim of the present work is to investigate the extent and type of hepatic involvement in diabetics by radionuclide scanning which is objective and not liable to the errors and difficulties inherent in the method of physical examination. The present study was performed on 40 diabetics, comprising 24 females and 16 males, aged between 17 and 80 years. Scanning was performed with 99m - Tc sulphur colloid using a rectilinear scanner and the gamma camera. The liver size was assessed from the scan pictures by the application of certain measurements and by surface area determination. The obtained results demonstrated marked discrepancy between the liver size as determined clinically and that evaluated by radionuclide scanning. By scintiscanning, the incidence of hepatic enlargement varied according to the parameter used. It amounted to 48% on the basis of the maximum vertical dimension and 37% with hepatic surface area measurement. Using the vertical dimension at halfway between the xiphoid and right lateral hepatic margin, the incidence of liver enlargement was 35%. Uneven distribution of radioactivity was seen in the right and/or left lobe in 20/40 patients. Furthermore, in 10 patients the ratio of hepatic to splenic radioactivity was below one. These changes could be explained by fatty infiltration and/or cirrhosis. Accordingly, hepatic scanning could be used to select diabetes having abnormal scan picture whether regarding liver dimensions or distribution of radioactivity and subjecting them to liver biopsy in order to define the nature of liver involvement. (Author)

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

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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.

Evaluation of Urinary Tryptophan Metabolite Levels in Non-diabetic Compared to Diabetic Rats

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Loredana Elena OLAR

2017-11-01

Full Text Available Diabetes mellitus is one of the most common metabolic disorders in animals. Thus, currently, it is imperative to introduce non-invasive, economical and rapid methods for the investigation of diabetes in animals. In this study, the urine samples collected from 10 non-diabetic and 10 streptozotocin-induced diabetic rats were investigated by the spectrofluorimetric technique. Emission spectra for the urine samples were obtained following an excitation wavelength of 280 and 400 nm. The investigated fluorophores were mainly tryptophan metabolites, and significant differences resulted between the mean heights of the emission bands attributed to these fluorophore compounds in diabetic compared to non-diabetic rats. The shape of the spectral windings after the utilization of these two excitation wavelengths was almost similar for diabetic and non-diabetic rats; however, there were some discriminatory elements between the two types of investigated samples. In conclusion, the obtained urine fluorescence spectra allow a clear differentiation between diabetic and non-diabetic rats.

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

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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.

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

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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.

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

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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.

Community Evaluation of the National Diabetes Education Program's Diabetes HealthSense Website.

Science.gov (United States)

Sadler, Michele DeBarthe; Saperstein, Sandra L; Carpenter, Carrie; Devchand, Roshni; Tuncer, Diane; O'Brian, Catherine; Nicols, Christina; Gallivan, Joanne

2017-10-01

Purpose The purpose of this study was to assess the impact of Diabetes HealthSense on knowledge, attitudes, and behavior changes that prevent, delay, or manage diabetes among people at risk (PAR) for diabetes and people with diabetes (PWD). Methods Using a 2-group pretest-posttest design, 15 community sites were randomly assigned to either an intervention or comparison group. Intervention participants attended a group education session with a diabetes educator, followed by 4 weeks of independent use of the Diabetes HealthSense website. The comparison group received no intervention. A total of 311 adults (n = 135 intervention, n = 176 comparison) completed both a pretest and posttest. Outcome measures examined changes in self-reported knowledge, self-efficacy, and behaviors that support diabetes prevention or management. Results Statistically significant within-group pretest to posttest changes were found for almost all outcome measures in the intervention group, with no significant changes in the comparison group. Significant between-group differences were also found for almost all outcome measures at posttest, with the intervention group having more positive outcomes than the comparison group. Conclusions Patient referral to online tools is considered one key component of initial and ongoing diabetes self-management education and support (DSME/S) and is recommended as a way to enhance and extend the reach of in-person diabetes education. Positive outcomes were found for PWD/PAR who used Diabetes HealthSense following a guided education session. Study results suggested that with guided exploration, Diabetes HealthSense provided a valuable tool for educators to use with patients to support and extend the reach of DSME/S.

MR evaluation of diabetes insipidus

International Nuclear Information System (INIS)

Tien, R.D.; Newton, T.H.; Kucharczyk, J.

1989-01-01

The authors have used MR imaging to evaluate the hypothalamic/pituitary region in 21 patients with central diabetes insipidus. Diagnoses included histiocytosis-X, germ cell tumors trauma, metastases, tuberculosis, pituitary abscess, and Erdheim-Chester disease. Gd-DTPA was administered in eight patients. Seventeen of 21 patients had a pituitary infundibular stalk that was thicker than that of normal subjects, but the signal intensity of the abnormal stalk was normal. The pituitary stalk was uniformly thickened in the histiocytosis-X and tuberculosis patients. Asymmetric thickening was seen in the patients with germ cell tumors, metastases, and Erdheim-Chester disease. Pituitary stalk was disrupted in the posterior pituitary lobe was absent in all patients

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

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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

Evaluative coping, emotional distress, and adherence in couples with Type 2 diabetes.

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Trump, Lisa J; Novak, Joshua R; Anderson, Jared R; Mendenhall, Tai J; Johnson, Matthew D; Scheufler, Ann C; Wilcox, Allison; Lewis, Virginia L; Robbins, David C

2018-03-01

Spousal support is one of the strongest and most consistent predictors of Type 2 diabetes treatment adherence. However, the effects of both spouses' evaluations of dyadic coping on emotional distress and patients' physical health remain largely unknown. Dyadic data from 117 married couples in which one member is diagnosed with Type 2 diabetes were evaluated in two separate models to explore the associations between (a) patients' and spouses' depression symptoms and patients' adherence to dietary and exercise regimens, and (b) patients' and spouses' acute stress levels and patients' adherence to dietary and exercise regimens. Finally, evaluative dyadic coping was included as a possible moderator between these associations. Results from an actor-partner interdependence model revealed significant actor effects of patients' depression symptoms on patients' adherence to dietary and exercise regimens. Spouses' evaluation of dyadic coping attenuated the direct paths between spouses' depression symptoms and patients' adherence to dietary regimens. No direct pathways were found from patients' or spouses' acute stress to patients' adherence to dietary and exercise regimens. However, spouses' evaluation of dyadic coping attenuated the direct paths between spouses' acute stress and patients' adherence to dietary regimens. Tapping into spouses' evaluations of dyadic coping has significant implications for patients' diabetes health outcomes (e.g., adherence to dietary and exercise treatment regimens). Findings from this study highlight the need for systemic interventions targeting both partners. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

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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.

Early evaluation of renal hemodynamic alterations in type I diabetes mellitus with duplex ultrasound

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Saif Aasem

2010-01-01

Full Text Available To evaluate the role of renal duplex ultrasonography in the detection of early alte-ration of renal blood flow in type I diabetic patients, we studied with duplex ultrasound 32 patients with type I diabetes mellitus (19 males, 13 females, age range 8-19 years and 35 age and sex-matched controls. The resistivity indices (RIs and pulsatility indices (PIs of the main renal as well as intra-renal arteries were calculated. Compared with the healthy control subjects, diabetic patients had significantly higher resistivity indices (RIs in the intrarenal (segmental, arcuate and interlobar ar-teries (P= 0.001. The study, also revealed a significantly positive correlation between the RIs in the intrarenal arteries in diabetics and the albumin/creatinine ratio (r= 0.54, 0.52 and 0.51 respectively, glycated hemoglobin (r= 0.61, 0.59 and 0.63 respectively, as well as the estimated GFR (e-GFR (r= 0.53, 0.51 and 0.57 respectively. We conclude that the current study documented early intra-renal hemodynamic alterations in the form of pathologically elevated intrarenal RIs. This denotes the potential usefulness of duplex evaluation of the intrarenal arteries, as a noninvasive procedure, for monitoring type 1 diabetic patients to predict those at risk of diabetic nephropathy.

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

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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.

Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center.

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Renda, Susan; Baernholdt, Marianne; Becker, Kathleen

2016-01-01

Evidence suggests that diabetes education can be delivered at the worksite to better support employees' diabetes self-management and improve productivity and health care costs. This study was conducted to address the feasibility of a diabetes worksite education program for employees at a large urban academic health care institution. The diabetes education program was delivered in the diabetes center at the institution, a resource that was previously underutilized by employees. Through collaboration with groups in the institution, 20 employees of diverse ethnicity participated in the worksite diabetes education program with positive outcomes: improved glycemic control measured (HbA1c), attainment of self-management goals, and satisfaction with the program. Work absences trended downward, but numbers of hospitalizations and emergency department visits were unchanged in the 3 months following education. Recommendations include replication of the study with more employee participation and program evaluation over a longer period of time to continue assessment of employees' educational needs. © 2015 The Author(s).

Thyroidal radio autographic evaluation in experimental diabetes mellitus

International Nuclear Information System (INIS)

Nascimento-Saba, C.C.A.; Brito, A.C.; Pereira, M.J.S.; Carvalho, J.J.; Roshental, D.

1997-01-01

Full text. There is a well known correlation between diabetes mellitus (DM) and thyroid diseases. Previous studies have shown that the thyroid peroxidase (TPO) 'in vitro' iodide-oxidation activity is decreased and the thyroid T 4-dasanide is increased 15 days after induction of experimental DM. In the present study we evaluated radioautography, an indirect assay of 'in vivo' T P O activity. D M was induced in male Wistar rats (circa 250 g body weight) by a single i.p. streptozotocin injection (45 mg/kg). One group of D M animals received insulin (2 U/day, N P H), starting 48 h after streptozotocin. 2μ Ci of 125 I were given by i.p. injection, 2.5 h before thyroid excision, after 7 or 30 days of diabetes. The glands were counted, weighed, fixed in Bouin's solution, embedded in paraffin, cut and HE-stained. The sections were covered with NTB-2 emulsion (Kodak), incubated at 4 deg C for 7 days, before revelation. Quantitative distribution of silver grains was evaluated using the Image Pro-Plus program. The thyroidal 125 I uptake is significantly decreased in diabetic animals after 30 days. The 'in vative P O activity is significantly decreased 7 and 30 days D M induction. This decrease was also present in the insulin-treated animals and the exogenous insulin administration was unable to revert changes induced by experimental D M, at least in the dosage/periodicity used. It seems that the activity of basal membrane is affected after 30 days of D M, however the T P O activity is already affected after 7 days of DM

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

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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

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.

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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.

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

OpenAIRE

Bakianian Vaziri, P.; Vahedi, M.; Mortazavi, H.; Abdollahzadeh, Sh.; Hajilooi, M.

2010-01-01

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. Nephelomet...

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.

Psychometric evaluation of the Problem Areas in Diabetes (PAID survey in Southern, rural African American women with Type 2 diabetes

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Elasy Tom A

2008-02-01

Full Text Available Abstract Background The Problem Areas in Diabetes (PAID survey is a measure of diabetes-related stress for which reported use has been in largely Caucasian populations. Our purpose was to assess the psychometric properties of the PAID in Southern rural African American women with Type 2 diabetes. Methods A convenience sample of African American women (N = 131 ranging from 21–50 years of age and diagnosed with Type 2 diabetes were recruited for a survey study from two rural Southern community health centers. Participants completed the PAID, Center for Epidemiological Studies-Depression Scale (CES-D, and the Summary of Diabetes Self-Care Activities Scale (SDSCA. Factor analysis, Cronbach's coefficient alpha, and construct validation facilitated psychometric evaluation. Results A principle component factor analysis of the PAID yielded two factors, 1 a lack of confidence subscale, and 2 a negative emotional consequences subscale. The Lack of Confidence and Negative Emotional Consequences subscales, but not the overall PAID scale, were associated with glycemic control and body mass index, respectively. Relationships with measures of depression and diabetes self-care supported construct validity of both subscales. Both subscales had acceptable (alpha = 0.85 and 0.94 internal consistency measures. Conclusion A psychometrically sound two-factor solution to the PAID survey is identified in Southern, rural African American women with Type 2 diabetes. Lack of confidence in and negative emotional consequences of diabetes self-care implementation provide a better understanding of determinants of glycemic control and weight than an aggregate of the two scales.

Economic evaluations of pharmacist-managed services in people with diabetes mellitus: a systematic review.

Science.gov (United States)

Wang, Y; Yeo, Q Q; Ko, Y

2016-04-01

To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services. © 2015 Diabetes UK.

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

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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.

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.

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

Science.gov (United States)

Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

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

AIMS: To adapt the Diabetes Health Profile (DHP-1) for use with English speaking patients with Type 2 diabetes mellitus and to evaluate the psychometric properties of the adapted measure in a UK and Danish sample of insulin, tablet and diet-treated patients with Type 2 diabetes. METHODS: Following...... items (56.25%) were retained following initial item analysis. A three-factor solution accounting for 45.6% and 40.3% of the total explained variance was identified in the UK and Danish samples, respectively. Factors were interpreted as psychological distress (PD), barriers to activity (BA...

Evaluating Parents' Self-Efficacy for Diabetes Management in Pediatric Type 1 Diabetes.

Science.gov (United States)

Noser, Amy E; Patton, Susana R; Van Allen, Jason; Nelson, Michael B; Clements, Mark A

2017-04-01

To examine the factor structure and construct validity of the Maternal Self-Efficacy for Diabetes Management Scale (MSED) in 135 youth ( Mage  = 13.50  ±  1.83 years), with type 1 diabetes mellitus. The study used exploratory factor analysis (EFA) to examine the factor structure and correlations to examine relationships among MSED factors and select parent and child diabetes-related health behaviors and outcomes. EFA identified an 11-item three-factor solution (χ 2 (25, n  = 133)  = 40.22, p  manage their child's diabetes (MSED-M), problem-solve issues surrounding glycemic control (MSED-P), and teach their child about diabetes care (MSED-T). Correlational analyses revealed significant associations between the MSED-M and MSED-T and parent-reported optimism and youth's diabetes-specific self-efficacy. The MSED-T was also associated with glycated hemoglobin and self-monitoring blood glucose. Results provide preliminary evidence for the reliability and validity of a three-factor solution of the MSED. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

2015-01-01

Background: 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). Methods: 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. Results: 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. Conclusions: 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. PMID:26635437

The Diabetes Self-management Assessment Report Tool (D-SMART): process evaluation and patient satisfaction.

Science.gov (United States)

Charron-Prochownik, Denise; Zgibor, Janice C; Peyrot, Mark; Peeples, Malinda; McWilliams, Janis; Koshinsky, Janice; Noullet, William; Siminerio, Linda M

2007-01-01

The purpose of this article is to present the results of the process evaluation and patient experience in completing the Diabetes Self-management Assessment Report Tool (D-SMART), an instrument within the AADE Outcome System to assist diabetes educators to assess, facilitate, and track behavior change in the provision of diabetes self-management education (DSME). The D-SMART was integrated into computer and telephonic systems at 5 sites within the Pittsburgh Regional Initiative for Diabetes Education (PRIDE) network. Data were obtained from 290 patients with diabetes using the system at these programs via paper-and-pencil questionnaires following baseline D-SMART assessments and electronic system measurement of system performance. Process evaluation included time of completion, understanding content, usability of technology, and satisfaction with the system. Patients were 58% female and 85% Caucasian and had a mean age of 58 years. Fifty-six percent of patients had no more than a high school education, and 78% had Internet access at home. Most patients reported completing the D-SMART at home (78%), in 1 attempt (86%) via the Internet (55%), and in less than 30 minutes. Seventy-six percent believed the questions were easy to understand, and 80% did not need assistance. Age was negatively associated with ease of use. Moreover, 76% of patients believed the D-SMART helped them think about their diabetes, with 67% indicating that it gave the diabetes educator good information about themselves and their diabetes. Most (94%) were satisfied with the D-SMART. Level of satisfaction was independent of the system being used. The D-SMART was easily completed at home in 1 attempt, content was understandable, and patients were generally satisfied with the wording of questions and selection of answers. The D-SMART is easy to use and enhanced communication between the patient and clinician; however, elderly patients may need more assistance. Computer-based and telephonic D

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)

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

International Nuclear Information System (INIS)

Goncalves, Rodolfo D.M.R.; Silva, Paulo S.C. da

2015-01-01

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)

Transperitoneal transport in diabetic and non-diabetic patients on peritoneal dialysis

DEFF Research Database (Denmark)

Graff, J; Fugleberg, Steen; Nielsen, S L

1999-01-01

To investigate differences in the transport characteristics of the peritoneal membrane between diabetic and non-diabetic patients on chronic peritoneal dialysis, a study was conducted in 21 non-diabetic and 18 diabetic patients. Transperitoneal transport of small solutes was evaluated in terms...... of the mass transfer area coefficients (urea, creatinine and glucose), ultra-filtration sieving coefficients (urea and creatinine) and by peritoneal equilibration test results. The capacity of the peritoneal membrane to transport macromolecules was evaluated by albumin mass transfer rates and clearances......-labelled human albumin. Despite a significantly increased transcapillary escape rate of albumin in the diabetic patients, no differences in peritoneal membrane characteristics could be demonstrated between diabetic and non-diabetic patients on peritoneal dialysis....

Clinical diagnosis of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic neuropathy examination scores

NARCIS (Netherlands)

Meijer, J.W.; Lefrandt, J.D.; Links, T.P.; Smit, J.A.; Stewart, R.E.; van der Hoeven, J.H.; Hoogenberg, K.

OBJECTIVE - To evaluate the discriminative power of the Diabetic Neuropathy Symptom (DNS) and Diabetic Neuropathy Examination (DNE) scores for diagnosing diabetic polyneuropathy (PNP), as well as their relation with cardiovascular autonomic function testing (cAFT) and electro-diagnostic studies

The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus.

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Rubino, Francesco; Kaplan, Lee M; Schauer, Philip R; Cummings, David E

2010-03-01

To develop guidelines for the use of gastrointestinal surgery to treat type 2 diabetes and to craft an agenda for further research. Increasing evidence demonstrates that bariatric surgery can dramatically ameliorate type 2 diabetes. Not surprisingly, gastrointestinal operations are now being used throughout the world to treat diabetes in association with obesity, and increasingly, for diabetes alone. However, the role for surgery in diabetes treatment is not clearly defined and there are neither clear guidelines for these practices nor sufficient plans for clinical trials to evaluate the risks and benefits of such "diabetes surgery." A multidisciplinary group of 50 voting delegates from around the world gathered in Rome, Italy for the first International Conference on Gastrointestinal Surgery to Treat Type 2 Diabetes--(the "Diabetes Surgery Summit"). During the meeting, available scientific evidence was examined and critiqued by the entire group to assess the strength of evidence and to draft consensus statements. Through an iterative process, draft statements were then serially discussed, debated, edited, reassessed, and finally presented for formal voting. After the Rome meeting, statements that achieved consensus were summarized and distributed to all voting delegates for further input and final approval. These statements were then formally critiqued by representatives of several sientific societies at the 1st World Congress on Interventional Therapies for T2DM (New York, Sept 2008). Input from this discussion was used to generate the current position statement. A Diabetes Surgery Summit (DSS) Position Statement consists of recommendations for clinical and research issues, as well as general concepts and definitions in diabetes surgery. The DSS recognizes the legitimacy of surgical approaches to treat diabetes in carefully selected patients. For example, gastric bypass was deemed a reasonable treatment option for patients with poorly controlled diabetes and a

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

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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.

[Evaluation of nopal capsules in diabetes mellitus].

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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.

Tests of perturbative and non perturbative structure of moments of hadronic event shapes using experiments JADE and OPAL

International Nuclear Information System (INIS)

Pahl, Christoph Johannes

2008-01-01

In hadron production data of the e + e - annihilation experiments JADE and OPAL we measure the first five moments of twelve hadronic-event-shape variables at c.m. energies from 14 to 207 GeV. From the comparison of the QCD NLO prediction with the data corrected by means of MC models about hadronization we obtain the reference value of the strong coupling α s (M Z 0 )=0.1254±0.0007(stat.)±0.0010(exp.) +0.0009 -0.0 0 23 (had.) +0.0069 -0.0053 (theo.). For some, especially higher moments, systematic unsufficiencies in the QCD NLO prediction are recognizable. Simultaneous fits to two moments under assumption of identical renormalization scales yield scale values from x μ =0.057 to x μ =0.196. We check predictions of different non-perturbative models. From the single-dressed-gluon approximation a perturbative prediction in O(α 5 s ) results with neglegible energy power correction, which describes the thrust average on hadron level well with α s (M Z 0 )=0.1186±0,0017(exp.) -0.0028 +0.0033 (theo.). The variance of the event-shape variable is measured and compared with models as well as predictions. [de

A web-based dietary intervention for people with type 2 diabetes: development, implementation, and evaluation.

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Ramadas, Amutha; Chan, Carina Ka Yee; Oldenburg, Brian; Hussien, Zanariah; Quek, Kia Fatt

2015-06-01

Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported. We describe the development, implementation, and process evaluation of an Internet-delivered dietary intervention program (myDIDeA) for diabetic patients in a developing country. Specific dietary components to be included in the intervention module were first identified through a comprehensive review of literature and guidelines. The lesson plans and the study website were then developed based on the evidence, Transtheoretical Model's Stages of Change and user-centered design approach. Finally, the effectiveness of the website was tested through a randomized-controlled trial to promote dietary change in patients with type 2 diabetes. The participants in the intervention group (n = 66) were given access to myDIDeA for 6 months. Process evaluation in form of intervention adherence and program reception were conducted at post intervention. The response rate for the process evaluation was 89%. On average, each participant logged in at least once for each lesson plan and spent almost 12 min on the site. The participants' content satisfaction, acceptability, and usability scores were satisfactory. The primary outcome of the trial, Dietary Knowledge, Attitude, and Behavior score was strongly correlated with content satisfaction (r = 0.826, p social media, and other means to stimulate the interest of participants can be explored.

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....

Clinical usefulness of multidetector-row CT to evaluate coronary artery calcium score in type 2 diabetes

International Nuclear Information System (INIS)

Nishioka, Makiko; Sakuma, Toru; Sano, Hironari; Utsunomiya, Kazunori; Agata, Toshihiko; Shimizu, Keisuke; Tajima, Naoko

2004-01-01

According to recent studies, multidetector-row CT (MDCT) with a retrospective electrocardiogram (ECG)-gating reconstruction algorithm shows a high correlation with coronary artery calcium score determined using electron-beam CT. Diabetes leads to many macrovascular complications, including coronary artery disease. The aim of this study was to evaluate risk factors for cardiac macroangiopathy in type 2 diabetes using MDCT. An observational cross-sectional study was performed in 90 patients with diabetes mellitus. Coronary calcium data was acquired by MDCT (SOMATOM Volume Zoom, Siemens AG, Medical Solutions, Germany). Physical examinations, laboratory data, glycemic control, and control of other risk factors were analyzed. The coronary artery calcium score increased with age. Multivariant analysis revealed that the coronary calcium score was closely correlated with electrocardiogram evaluation and control of hypertension. Coronary artery calcium score as determined by MDCT can be used as a screening radiological examination for cardiac macroangiopathy in diabetes patients with electrocardiogram abnormality and hypertension. (author)

Evaluation of the spoken knowledge in low literacy in diabetes scale for use with Mexican Americans.

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Garcia, Alexandra A; Zuniga, Julie; Reynolds, Raquel; Cairampoma, Laura; Sumlin, Lisa

2015-05-01

This article evaluates the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) questionnaire, a measure of essential knowledge for type 2 diabetes self-management, after it was modified for English- and Spanish-speaking Mexican Americans. We collected surveys (SKILLD, demographic, acculturation) and blood for A1C analysis from 72 community-recruited participants to analyze the SKILLD's internal consistency, interrater reliability, item analysis, and construct validity. Clinical experts evaluated content validity. The SKILLD demonstrated low internal consistency but high interrater reliability and content and construct validity. There were significant correlations in expected directions between SKILLD scores and acculturation, education, and A1C and significant differences in SKILLD scores between and within groups after an educational intervention and between high- and low-acculturated participants. The SKILLD generates useful information about Mexican Americans' diabetes knowledge. Lower SKILLD scores suggest less diabetes knowledge, lower health literacy, and participants' difficulties understanding items. Further modifications should improve use with low-acculturated Mexican Americans. © The Author(s) 2014.

Evaluation of peripheral vasodilative indices in skin tissue of type 1 diabetic rats by use of RGB images

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Tanaka, Noriyuki; Nishidate, Izumi; Nakano, Kazuya; Aizu, Yoshihisa; Niizeki, Kyuichi

2016-04-01

We investigated a method to evaluate the arterial inflow and the venous capacitance in the skin tissue of streptozotocin-induced type 1 diabetic rats from RGB digital color images. The arterial inflow and the venous capacitance in the dorsal reversed McFarlane skin flap are calculated based on the responses of change in the total blood concentration to occlusion of blood flow to and from the flap tissues at a pressure of 50 mmHg. The arterial inflow and the venous capacitance in the skin flap tissue were significantly reduced in type 1 diabetic rat group compared with the non-diabetic rat group. The results of the present study indicate the possibility of using the proposed method for evaluating the peripheral vascular dysfunctions in diabetes mellitus.

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

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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…

Autoradiographic thyroid evaluation in short-term experimental diabetes mellitus

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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

Estimating the incremental net health benefit of requirements for cardiovascular risk evaluation for diabetes therapies.

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Chawla, Anita J; Mytelka, Daniel S; McBride, Stephan D; Nellesen, Dave; Elkins, Benjamin R; Ball, Daniel E; Kalsekar, Anupama; Towse, Adrian; Garrison, Louis P

2014-03-01

To evaluate the advantages and disadvantages of pre-approval requirements for safety data to detect cardiovascular (CV) risk contained in the December 2008 U.S. Food and Drug Administration (FDA) guidance for developing type 2 diabetes drugs compared with the February 2008 FDA draft guidance from the perspective of diabetes population health. We applied the incremental net health benefit (INHB) framework to quantify the benefits and risks of investigational diabetes drugs using a common survival metric (life-years [LYs]). We constructed a decision analytic model for clinical program development consistent with the requirements of each guidance and simulated diabetes drugs, some of which had elevated CV risk. Assuming constant research budgets, we estimate the impact of increased trial size on drugs investigated. We aggregate treatment benefit and CV risks for each approved drug over a 35-year horizon under each guidance. The quantitative analysis suggests that the December 2008 guidance adversely impacts diabetes population health. INHB was -1.80 million LYs, attributable to delayed access to diabetes therapies (-0 .18 million LYs) and fewer drugs (-1.64 million LYs), but partially offset by reduced CV risk exposure (0.02 million LYs). Results were robust in sensitivity analyses. The health outcomes impact of all potential benefits and risks should be evaluated in a common survival measure, including health gain from avoided adverse events, lost health benefits from delayed or for gone efficacious products, and impact of alternative policy approaches. Quantitative analysis of the December 2008 FDA guidance for diabetes therapies indicates that negative impact on patient health will result. Copyright © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

Evaluation of salivary glucose, IgA and flow rate in diabetic patients: a case-control study.

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Bakianian Vaziri, P; Vahedi, M; Mortazavi, H; Abdollahzadeh, Sh; Hajilooi, M

2010-01-01

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. 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. Nephelometric and Pars method were used to measure salivary IgA and salivary glucose concentrations, respectively. Statistical analysis was performed by Chi-square and t test. 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 (Pdiabetic patients than the controls. Determination of salivary constituents may be useful in the description and management of oral findings in diabetic patients.

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

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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.

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

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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

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

Diabetes and Cognitive Decline in Older Adults: The Ginkgo Evaluation of Memory Study.

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Palta, Priya; Carlson, Michelle C; Crum, Rosa M; Colantuoni, Elizabeth; Sharrett, A Richey; Yasar, Sevil; Nahin, Richard L; DeKosky, Steven T; Snitz, Beth; Lopez, Oscar; Williamson, Jeff D; Furberg, Curt D; Rapp, Stephen R; Golden, Sherita Hill

2017-12-12

Previous studies have shown that individuals with diabetes exhibit accelerated cognitive decline. However, methodological limitations have limited the quality of this evidence. Heterogeneity in study design, cognitive test administration, and methods of analysis of cognitive data have made it difficult to synthesize and translate findings to practice. We analyzed longitudinal data from the Ginkgo Evaluation of Memory Study to test our hypothesis that older adults with diabetes have greater test-specific and domain-specific cognitive declines compared to older adults without diabetes. Tests of memory, visuo-spatial construction, language, psychomotor speed, and executive function were administered. Test scores were standardized to z-scores and averaged to yield domain scores. Linear random effects models were used to compare baseline differences and changes over time in test and domain scores among individuals with and without diabetes. Among the 3,069 adults, aged 72-96 years, 9.3% reported diabetes. Over a median follow-up of 6.1 years, participants with diabetes exhibited greater baseline differences in a test of executive function (trail making test, Part B) and greater declines in a test of language (phonemic verbal fluency). For the composite cognitive domain scores, participants with diabetes exhibited lower baseline executive function and global cognition domain scores, but no significant differences in the rate of decline. Identifying cognitive domains most affected by diabetes can lead to targeted risk modification, possibly in the form of lifestyle interventions such as diet and physical activity, which we know to be beneficial for improving vascular risk factors, such as diabetes, and therefore may reduce the risk of executive dysfunction and possible dementia. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

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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…

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

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Jung Min Kim

2016-04-01

Full Text Available BackgroundOneTouch 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.MethodsAll 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.ResultsWe 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.ConclusionUsing 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.

Evaluation of antioxidant status of female diabetic patients in Nnamdi Azikiwe University Teaching Hospital, Anambra State, Nigeria.

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Okuonghae, E O P; Onyenekwe, C C; Ahaneku, J E; Ukibe, N R; Nwani, P O; Asomugha, A L; Osakue, N O; Aidomeh, F; Awalu, C C

2015-01-01

Diabetes mellitus has become an onerous disease to developing countries such as Nigeria. Rapid acceptance of urbanisation and sedentary life styles pose an encumbrance to its prevention and management. Increased oxidative stress in diabetes mellitus has been implicated as a culprit in perpetuating antioxidant depletion and diabetic complications in diabetes mellitus individuals. This study aims to evaluate the level of antioxidant status in type 2 diabetes mellitus (DM) female participants visiting the out-patient diabetic clinic of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. A total of 86 participants aged 51±10 years were recruited for this study. The test group consists of 43 already confirmed type 2 diabetes mellitus females, while the control group consists of 43 apparently healthy females. The test subjects were further subgrouped into good and poor glycaemic control groups, using a cut-off of 0.05). This study concludes that there is antioxidant depletion in females with type 2 diabetes.

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

Evaluation of the Effects of Novel Nafimidone Derivatives on Thermal Hypoalgesia in Mice with Diabetic Neuropathy

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Suat Kamışlı

2013-03-01

Full Text Available Objective: Diabetic neuropathy (DN is a common complication in Diabetes Mellitus. The streptozotocin-induced diabetic rodent is the most commonly used animal model of diabetes and increased sodium channel expression and activity were revealed in this model. At this study, we evaluated the effect of three different nafimidone derivatives which have possible anticonvulsant activity on disorders of thermal pain sensation in diabetic mice. Study Design: Randomized animal experiment. Material and Methods: Mice were divided randomly into five groups (5 mice per group: Control, Diabetes, Dibetes+C1, Diabetes+C2, Diabetes+C3. We used hot and cold plate, and tail-immersion tests for assessment of thermal nociceptive responses. Results: Compared with the control group, the hot-plate response time and the number of paw liftings on cold plate as important indicators of loss of sensation increased, but no significant difference (p>0.05 was found in tail-immersion response time test in diabetes group. C3 compound moved it back to control group levels in the all of three tests. C1 and C2 compounds were effective only in cold-plate test. Conclusion: Nafimidone derivatives may be effective in the cases where epilepsy and diabetes occur together since it has shown efficacy against “loss of sensation” which evolves in diabetic neuropathy over time as well as its antiepileptic effect.

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

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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 (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.

Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

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M.C. Boelter

2006-08-01

Full Text Available Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001. Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001, insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001 and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011 were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001 was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002 remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

[Multicenter evaluation of the Nutri-Expert Telematic System in diabetic patients].

Science.gov (United States)

Turnin, M C; Bolzonella-Pene, C; Dumoulin, S; Cerf, I; Charpentier, G; Sandre-Banon, D; Valensi, P; Grenier, J L; Cathelineau, G; Mattei, C

1995-02-01

Nutri-Expert is a system for self-monitoring and dietetic education, accessible through Minitel. A preliminary randomised evaluation of one hundred diabetic patients in the Midi-Pyrénées region showed that Nutri-Expert improved dietetic knowledge, dietary habits and metabolic balance. The aim of the present study was to show that the system can be successfully prescribed to patients by physicians outside the center which originated it, indicating the benefit of a wider use of Nutri-Expert, among the diabetic population. One hundred and fifty-five patients, recruited by six French centres of diabetology, used Nutri-Expert from their homes for six months. Clinical examination, tests of dietetic knowledge and biological tests, including lipid fractions, were carried out before and after six months of use. After six months, there was a significant improvement in the patients' dietetic knowledge and in some biological parameters. Nutri-Expert is thus useful even when prescribed by a centre other than the hospital which devised the system. It is an additional beneficial tool in the ambulatory management of diabetic patients.

Evaluating the Association between Diabetes, Cognitive Decline and Dementia

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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.

Multiagent Systems Based Modeling and Implementation of Dynamic Energy Management of Smart Microgrid Using MACSimJX

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Raju, Leo; Milton, R. S.; Mahadevan, Senthilkumaran

2016-01-01

The objective of this paper is implementation of multiagent system (MAS) for the advanced distributed energy management and demand side management of a solar microgrid. Initially, Java agent development environment (JADE) frame work is used to implement MAS based dynamic energy management of solar microgrid. Due to unstable nature of MATLAB, when dealing with multithreading environment, MAS operating in JADE is linked with the MATLAB using a middle ware called Multiagent Control Using Simulink with Jade Extension (MACSimJX). MACSimJX allows the solar microgrid components designed with MATLAB to be controlled by the corresponding agents of MAS. The microgrid environment variables are captured through sensors and given to agents through MATLAB/Simulink and after the agent operations in JADE, the results are given to the actuators through MATLAB for the implementation of dynamic operation in solar microgrid. MAS operating in JADE maximizes operational efficiency of solar microgrid by decentralized approach and increase in runtime efficiency due to JADE. Autonomous demand side management is implemented for optimizing the power exchange between main grid and microgrid with intermittent nature of solar power, randomness of load, and variation of noncritical load and grid price. These dynamics are considered for every time step and complex environment simulation is designed to emulate the distributed microgrid operations and evaluate the impact of agent operations. PMID:27127802

Multiagent Systems Based Modeling and Implementation of Dynamic Energy Management of Smart Microgrid Using MACSimJX.

Science.gov (United States)

Raju, Leo; Milton, R S; Mahadevan, Senthilkumaran

The objective of this paper is implementation of multiagent system (MAS) for the advanced distributed energy management and demand side management of a solar microgrid. Initially, Java agent development environment (JADE) frame work is used to implement MAS based dynamic energy management of solar microgrid. Due to unstable nature of MATLAB, when dealing with multithreading environment, MAS operating in JADE is linked with the MATLAB using a middle ware called Multiagent Control Using Simulink with Jade Extension (MACSimJX). MACSimJX allows the solar microgrid components designed with MATLAB to be controlled by the corresponding agents of MAS. The microgrid environment variables are captured through sensors and given to agents through MATLAB/Simulink and after the agent operations in JADE, the results are given to the actuators through MATLAB for the implementation of dynamic operation in solar microgrid. MAS operating in JADE maximizes operational efficiency of solar microgrid by decentralized approach and increase in runtime efficiency due to JADE. Autonomous demand side management is implemented for optimizing the power exchange between main grid and microgrid with intermittent nature of solar power, randomness of load, and variation of noncritical load and grid price. These dynamics are considered for every time step and complex environment simulation is designed to emulate the distributed microgrid operations and evaluate the impact of agent operations.

Computed tomographical evaluation of diabetic nephropathy

International Nuclear Information System (INIS)

Ubara, Yoshifumi; Hara, Shigeko; Arizono, Kenji; Katori, Hideyuki; Yamada, Akira; Mimura, Nobuhide; Hagura, Ryoko.

1996-01-01

Diabetic nephropathy can be regarded mainly as a type of microangiopathy, but is a disease that may also include aspects of macroangiopathy. This is especially true of renal disease in non-insulin dependent diabetes mellitus (NIDDM), which is characterized not only by diabetic glomerulosclerosis, but also by atherosclerosis. We performed morphological studies on the kidney, using computed tomography (CT), focusing on such points as: abdominal aortic calcifications at the level of kidney, calcifications in the renal artery, and wedge-shaped defects on the renal surface. We noted that these findings became more prominent in NIDDM patients during end-stage renal failure than during normal renal function, and were significantly more common in those two NIDDM groups than in age-matched nondiabetic patients without hypertension, hyperlipidemia or gout. NIDDM patients exhibited these features more frequently than IDDM patients. (author)

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

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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.

Evaluation of thyroid dysfunction and autoimmunity in gestational diabetes mellitus and its relationship with postpartum thyroiditis.

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Maleki, N; Tavosi, Z

2015-02-01

To evaluate thyroid dysfunction and autoimmunity in women with gestational diabetes and to investigate the frequency of postpartum thyroiditis in women with gestational diabetes. A total of 350 women with gestational diabetes and 350 healthy pregnant women were enrolled in the study. We studied the thyroid hormone profiles of the women in each group during pregnancy (at 24-28 weeks' gestation) and after delivery (at 6 weeks, 3, 6 and 9 months, and 1 year postpartum). A total of 342 women with gestational diabetes and 313 healthy pregnant women completed the follow-up during pregnancy and 1 year after delivery. Of the women with gestational diabetes, 16.6% had thyroid dysfunction, while of the healthy pregnant women, 6.1% had thyroid dysfunction. The prevalence of postpartum thyroiditis was higher in the women with a history of gestational diabetes (19.6%) than in the healthy pregnant women (10.2%), and this difference was statistically significant. According to the results of the present study, the prevalence of postpartum thyroiditis was higher in women with a history of gestational diabetes than in healthy women. We recommend that all women with gestational diabetes and women who have previous thyroid dysfunction should be screened for thyroid hormonal abnormalities during pregnancy and for 1 year after pregnancy. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

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

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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.

MR imaging evaluation of diabetic foot

International Nuclear Information System (INIS)

Beltran, J.; Campanini, D.S.; McCalla, M.; Knight, C.T.

1988-01-01

Fourteen diabetic patients with suspected foot infection and/or neuropathic joint were evaluated with MR imaging to identify the presence and extent of infection and also to exclude coexistent infection in the neuropathic joint. Osteomyelitis (n = 8), abscess (n = 7), septic arthritis (n = 4), tenosynovitis (n = 4), and neuropathic joint (n = 5) were diagnosed with MR imaging. Osteomyelitis and/or abscess were excluded by MR findings in 13 instances. Most patients with infection had one more than one site of involvement. Clinical or surgical confirmation of the MR diagnoses was obtained in all but nine of the infection sites or cases of neuropathic joint. Only one false-negative diagnosis of osteomyelitis was made in this series. It is concluded that MR imaging provided accurate information regarding the presence and extent of infection and that this information was decisive in patient management

Evaluation of Glycemic and Lipid Profile of Offspring of Diabetic Wistar Rats Treated with Malpighia emarginata Juice

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Sandra M. Barbalho

2011-01-01

Full Text Available Knowing that maternal diabetes is related to hyperglycemia and fetal hyperinsulinemia, which affect the lipid metabolism, the aim of this study was to evaluate the effects of Malpighia emarginata (acerola juice on the glycemic and lipid profile of offspring of diabetic and nondiabetic Wistar rats. The adult offspring of non-diabetic dams and of dams with severe streptozotocin-induced diabetes were divided into groups: G1, offspring (of control dams treated with water, G2, offspring (of diabetic dams treated with water, G3, male offspring (of control dams treated with acerola juice, and G4, male offspring (of diabetic dams treated with acerola juice. The offspring of diabetic dams treated with acerola juice showed significantly decreased levels of glucose, cholesterol, triglycerides, and increased HDL-c. The use of acerola juice is a potential strategy to aid in the prevention of DM and dyslipidemia and its complications or to act as an auxiliary in the treatment of these diseases.

Evidence into practice: evaluating a child-centred intervention for diabetes medicine management The EPIC Project

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Rycroft-Malone Joanne

2010-09-01

Full Text Available Abstract Background There is a lack of high quality, child-centred and effective health information to support development of self-care practices and expertise in children with acute and long-term conditions. In type 1 diabetes, clinical guidelines indicate that high-quality, child-centred information underpins achievement of optimal glycaemic control with the aim of minimising acute readmissions and reducing the risk of complications in later life. This paper describes the development of a range of child-centred diabetes information resources and outlines the study design and protocol for a randomized controlled trial to evaluate the information resources in routine practice. The aim of the diabetes information intervention is to improve children and young people's quality of life by increasing self-efficacy in managing their type 1 diabetes. Methods/Design We used published evidence, undertook qualitative research and consulted with children, young people and key stakeholders to design and produce a range of child-centred, age-appropriate children's diabetes diaries, carbohydrate recording sheets, and assembled child-centred, age-appropriate diabetes information packs containing published information in a folder that can be personalized by children and young people with pens and stickers. Resources have been designed for children/young people 6-10; 11-15; and 16-18 years. To evaluate the information resources, we designed a pragmatic randomized controlled trial to assess the effectiveness, cost effectiveness, and implementation in routine practice of individually tailored, age-appropriate diabetes diaries and information packs for children and young people age 6-18years, compared with currently available standard practice. Children and young people will be stratified by gender, length of time since diagnosis ( 2years and age (6-10; 11-15; and 16-18 years. The following data will be collected at baseline, 3 and 6 months: PedsQL (generic

Ultrastructural evaluation of the effects of cinnamon on the nervus ischiadicus in diabetic rats

International Nuclear Information System (INIS)

Bahceci, Selen; Akkus, Murat; Aluclu, Mehmet U; Canoruc, Naime; Bahceci, Mithat; Gokalp, Deniz; Baran, Sedat; Akbalik, Mehmet E

2009-01-01

To investigate the effects of oral cinnamon supplementation on the nervus ischiadicus at the electron microscopical level in rats. This study was performed between 2004-2006 in Dicle University School of Medicine, Diyarbakir, Turkey in 15 adult Sprague-Dawley rats. Rats were divided into 3 groups; control (C) (n=5), diabetic without cinnamon (D) (n=5), and diabetic with cinnamon (D-C) (n=5). Diabetes was induced with intraperitoneal alloxan administration. All diabetic rats were treated with human insulin. All rats were fed with standard pellet chow. The D-C group rats were fed with standard pellet chow plus Cinnamomum cassia at the dose of 400mg/kg. All rats were sacrificed after 3 months and we obtained the nervus ischiadicus of all rats. Contrast stained thin sections evaluated by Jeol-TEM-1010 electron microscope, were not statistically different in both groups and photo samples were obtained. Mean blood glucose, hemoglobin A1C, and lipid profile were not statistically different in both groups. Marked detachment of myelin lamellae at Schmidt-Lanterman clefts, lysis in cristae mitochondrialis and degenerative changes, severe dispersion of organelles in neurolemma, mesoaxon region, and remarkable edema at the endoneurium were found in diabetic rats. On the contrary, mesoaxon, nucleus, nucleolus and myelin sheet were almost of normal appearance at the ultra-structural level in the D-C group. Cinnamon extracts may have beneficial effects on the development of diabetic neuropathy in alloxan induced diabetic rats. (author)

Powerful together with diabetes : The development and evaluation of a social network based intervention for Dutch, Surinamese, Turkish and Moroccan people with type 2 diabetes living in socioeconomically deprived neighbourhoods

NARCIS (Netherlands)

Vissenberg, C.

2017-01-01

This thesis describes the development and evaluation of the social network based intervention Powerful Together with Diabetes (PTWD) targeted at Dutch, Turkish, Moroccan and Surinamese patients with type 2 diabetes living in socioeconomically deprived neighbourhoods. This intervention aims to

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

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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.

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

2017-12-01

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 Pnutritional 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.

Retinal changes in diabetic patients without diabetic retinopathy.

Science.gov (United States)

Dumitrescu, Alina Gabriela; Istrate, Sinziana Luminita; Iancu, Raluca Claudia; Guta, Oana Maria; Ciuluvica, Radu; Voinea, Liliana

2017-01-01

The purpose of this study was to measure retinal vessel caliber and to examine early changes in macular thickness using optical coherence tomography (OCT). We evaluated to what extend vascular caliber and macular thickness differed between patients with type 2 diabetes mellitus without diabetic retinopathy compared with healthy individuals. 26 diabetic patients without diabetic retinopathy and 26 normal participants without any retinal and optic nerve diseases underwent ophthalmic examination, fundus photography, and OCT imaging. Temporal inferior retinal vessel diameters were measured using OCT. Also, we measured macular thickness in nine ETDRS subfields using Cirrus OCT. The mean age in the diabetic group was 61.5 years and in the control group, 55.5 years. Wider retinal arterioles and venules were found in patients with diabetes compared with healthy subjects (120 µm versus 96 µm, pdiabetes mellitus, central macular thickness was significantly thinner than that of control eyes (243.5 µm versus 269.9 µm, p value diabetes without diabetic retinopathy.

[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.

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

African Journals Online (AJOL)

HP

Purpose: To determine the prevalence of smoking among diabetes patients attending Diabetes. Outpatient Clinic at Penang .... (2,547) medical records of type 1 and 2 diabetes patients were .... American Diabetes Association. Standards of ...

Evaluation of Smoking, Diabetes Mellitus and Obesity associations with Degenerative Lumbar Spinal Stenosis in Elderly

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Laith Thamer Al-Ameri

2018-05-01

Full Text Available Background: Degenerative lumbar spinal stenosis (LSS is a common condition affecting mainly old age group with high incidence and prevalence, and is associated with many factors. Aim: Our study aimed to evaluate smoking, diabetes mellitus and obesity associations with degenerative LSS. Patients and methods: A comparative crosssectional study with participants aged 60 years or older. Participants suffering from degenerative LSS were enrolled as the diseased group after diagnosis with MRI, healthy persons (age and gender matched were considered as control group. Smoking, diabetes mellitus and obesity variables were collected and analyzed using chi-square and odds ratio. Results: Around 162 participants enrolled the study, 62 were considered as degenerative LSS group, whereas 100 were considered as the control group. In LSS group, a picture obtained was of 20:42 smokers to non-smoker, 22:20 diabetic to non-diabetic, 37:25 obese to non-obese. While in the controlled group a picture was obtained with 18:82 smokers to non-smoker, 18-82 diabetic to non-diabetic, 34:66 obese to non-obese. Chi-square p-value was of 0.037, 0.012 and 0.001 for smoking, diabetes mellitus, and obesity, respectively. The odd ratio was 2.17, 2.5 and 2.87 for smoking, diabetes mellitus, and obesity, respectively. All above results were significant. Conclusion: Each of smoking, diabetes mellitus, and obesity has a great association with the development of degenerative LSS in elderly age group. Obesity shows the highest association among them

Blood pressure control with amlodipine add-on therapy in patients with hypertension and diabetes: results of the Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial.

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Kloner, Robert A; Neutel, Joel; Roth, Eli M; Weiss, Robert; Weinberger, Myron H; Thakker, Kamlesh M; Schwartz, Brian; Shi, Harry; Gregg, Anne-Marie

2008-11-01

Attainment of blood pressure (BP) goals in patients with diabetes is critical both to reduce the risk of cardiovascular events and to delay the progression of renal disease. While therapeutic guidelines advise initial therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, monotherapy with these agents may not be sufficient to attain target BP. The ADHT (Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial) evaluated the efficacy and safety of adding amlodipine to the treatment regimen of patients with hypertension and diabetes who were already receiving either quinapril or losartan as monotherapy. ADHT was a double-blind, double-dummy, 22-week trial conducted in the US. After a washout period of 7-13 days, patients (aged 30-75 y) with hypertension and diabetes were randomized to receive quinapril 20 mg/day plus placebo or losartan 50 mg/day plus placebo for 4 weeks, titrated to 40 mg or 100 mg (if required), respectively, for an additional 4 weeks to achieve their BP goals (<130/80 mm Hg). At week 8, either amlodipine 5 mg/day or placebo was added for an additional 12 weeks, with titration to 10 mg at week 14 if the BP goal was not achieved. Efficacy of add-on therapy was evaluated in 411 patients (amlodipine 211, placebo 200). BP goal was reached by 27.5% of patients when amlodipine was added to quinapril or losartan monotherapy, compared with 12.5% when placebo was added (OR 2.73; 95% CI 1.61 to 4.64; p < 0.001). When added to quinapril or losartan monotherapy, amlodipine reduced BP by 8.1/5.4 mm Hg, compared with a 1.6/0.7 mm Hg decrease with add-on placebo (p < 0.001). Amlodipine, quinapril, and losartan were well tolerated. Amlodipine is safe and effective when added to quinapril or losartan monotherapy to help lower BP toward therapeutic targets in patients with hypertension and diabetes.

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.

Anti-diabetic effects of rice hull smoke extract in alloxan-induced diabetic mice

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We investigated the protective effect of a liquid rice hull smoke extract (RHSE) against diabetes in alloxan-induced diabetic mice. Anti-diabetic effects of RHSE were evaluated in both the rat insulinoma-1 cell line (INS-1) and diabetic ICR mice induced by inraperitoneal (ip) injection of alloxan. ...

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

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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.

Evaluation of BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients.

Science.gov (United States)

Derosa, Giuseppe; Maffioli, Pamela; Rosati, Alessandra; M, De Marco; Basile, Anna; D'Angelo, Angela; Romano, Davide; Sahebkar, Amirhossein; Falco, Antonia; Turco, Maria C

2018-03-01

BAG3 is a member of human BAG (Bcl-2-associated athanogene) proteins and plays a role in apoptosis, cell adhesion, cytoskeleton remodeling, and autophagy. The aim of this study was to evaluate BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients. We enrolled 209 Caucasian adults, of both sex, 18-75 years of age, 77 were healthy controls, 62 were affected by hypertension, and 70 were affected by hypertension and type 2 diabetes. All patients underwent an assessment that included medical history, physical examination, vital signs, a 12-lead electrocardiogram, measurements of systolic (SBP), and diastolic blood pressure (DBP), heart rate (HR), fasting plasma glucose (FPG), glycated hemoglobin (HbA 1c ), triglycerides (TG), transaminases, high sensitivity C-reactive protein (Hs-CRP), and BAG3. We observed higher blood pressure values in hypertensive, and hypertensive diabetic patients compared to controls. As expected, FPG and HbA 1c were higher in diabetic hypertensive patients, compared to the other two groups. No Tg levels differences were recorded among the three groups. Hs-CRP was higher in diabetic hypertensive patients compared to healthy subjects. Finally, BAG3 levels were higher in hypertensives, and hypertensive diabetic patients compared to controls. We observed higher levels of BAG3 in hypertensive patients compared to healthy controls, and even higher levels in hypertensive diabetic patients compared to healthy subjects. This paper could be the first of a long way to identify potential involvement of deregulated BAG3 levels in cardiometabolic diseases. © 2017 Wiley Periodicals, Inc.

Prevalence of self-reported diagnosis of diabetes mellitus and associated risk factors in a national survey in the US population: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes).

Science.gov (United States)

Bays, Harold E; Bazata, Debbra D; Clark, Nathaniel G; Gavin, James R; Green, Andrew J; Lewis, Sandra J; Reed, Michael L; Stewart, Walter; Chapman, Richard H; Fox, Kathleen M; Grandy, Susan

2007-10-03

Studies derived from continuous national surveys have shown that the prevalence of diagnosed diabetes mellitus in the US is increasing. This study estimated the prevalence in 2004 of self-reported diagnosis of diabetes and other conditions in a community-based population, using data from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). The initial screening questionnaire was mailed in 2004 to a stratified random sample of 200,000 households in the US, to identify individuals, age > or = 18 years of age, with diabetes or risk factors associated with diabetes. Follow-up disease impact questionnaires were then mailed to a representative, stratified random sample of individuals (n = 22,001) in each subgroup of interest (those with diabetes or different numbers of risk factors for diabetes). Estimated national prevalence of diabetes and other conditions was calculated, and compared to prevalence estimates from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. Response rates were 63.7% for the screening, and 71.8% for the follow-up baseline survey. The SHIELD screening survey found overall prevalence of self-reported diagnosis of diabetes (either type 1 or type 2) was 8.2%, with increased prevalence with increasing age and decreasing income. In logistic regression modeling, individuals were more likely to be diagnosed with type 2 diabetes if they had abdominal obesity (odds ratio [OR] = 3.50; p or =28 kg/m2 (OR = 4.04; p self-report only) to those from NHANES 1999-2002 (self-report, clinical and laboratory evaluations), the prevalence of diabetes was similar. SHIELD allows the identification of respondents with and without a current diagnosis of the illness of interest, and potential longitudinal evaluation of risk factors for future diagnosis of that illness.

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.

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

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

Myocardial involvement in diabetic patients evaluated by exercise thallium-201 scintigraphy and cardiac catheterization

International Nuclear Information System (INIS)

Mizuno, Sumio; Genda, Akira; Nakayama, Akira; Igarashi, Yutaka; Takeda, Ryoyu

1985-01-01

To evaluate myocardial involvement in diabetes mellitus, we studied 39 patients with negative double-Master's test and without hypertension by exercise thallium-201 (Tl-201) myocardial scintigraphy using a bicycle ergometer. Among the 39 patients, 12 (30.8 %) showed filling defects in the scintigrams (positive cases), including eight with stress-induced defects and four with fixed defects. The positive cases had higher scores of diabetic complications (3.6 +- 2.4 vs 2.1 +- 1.8; p < 0.05) and longer durations of diabetes as compared with those of the negative cases. The frequency of insulin therapy was also greater in the positive cases. Eleven patients (5 positive and 6 negative cases) who underwent cardiac catheterization had no significant stenotic lesions of their coronary arteries. However, all of the positive cases showed abnormal wall motion, mainly hypokinesis, by left ventriculography (LVG). The abnormalities of the LVG corresponded to the findings of the scintigrams (i.e. filling defects and decrease in washout ratios by circumferential profile analysis). These results suggest that in some diabetics myocardial involvement exists in the early stage without overt cardiac disease and exercise Tl-201 scintigraphy is useful in detecting pre-clinical cardiomyopathy. Cardiomyopathy in diabetics seems to be due to disturbances of the myocardial microcirculation. (author)

Development and validation of a questionnaire to evaluate patient satisfaction with diabetes disease management.

Science.gov (United States)

Paddock, L E; Veloski, J; Chatterton, M L; Gevirtz, F O; Nash, D B

2000-07-01

To develop a reliable and valid questionnaire to measure patient satisfaction with diabetes disease management programs. Questions related to structure, process, and outcomes were categorized into 14 domains defining the essential elements of diabetes disease management. Health professionals confirmed the content validity. Face validity was established by a patient focus group. The questionnaire was mailed to 711 patients with diabetes who participated in a disease management program. To reduce the number of questionnaire items, a principal components analysis was performed using a varimax rotation. The Scree test was used to select significant components. To further assess reliability and validity; Cronbach's alpha and product-moment correlations were calculated for components having > or =3 items with loadings >0.50. The validated 73-item mailed satisfaction survey had a 34.1% response rate. Principal components analysis yielded 13 components with eigenvalues > 1.0. The Scree test proposed a 6-component solution (39 items), which explained 59% of the total variation. Internal consistency reliabilities computed for the first 6 components (alpha = 0.79-0.95) were acceptable. The final questionnaire, the Diabetes Management Evaluation Tool (DMET), was designed to assess patient satisfaction with diabetes disease management programs. Although more extensive testing of the questionnaire is appropriate, preliminary reliability and validity of the DMET has been demonstrated.

Psychometric evaluation of the short version of the Personal Diabetes Questionnaire to assess dietary behaviors and exercise in patients with type 2 diabetes.

Science.gov (United States)

Akohoue, Sylvie A; Wallston, Kenneth A; Schlundt, David G; Rothman, Russell L

2017-08-01

Patients with diabetes and of lower socioeconomic status have difficulty adhering to dietary recommendations. Practical and effective tools assessing self-management behaviors are needed to help evaluate interventions tailored to the needs of individual patients or population groups. This study examined the psychometric properties of a short 11-item version of the Personal Diabetes Questionnaire scale (PDQ-11) using data from the Public-Private Partnership to Improve Diabetes Education trial. Patients (n=411) with type 2 diabetes from ten safety net primary care clinics in the Mid-Cumberland Region of Tennessee completed the PDQ-11, the Summary of Diabetes Self-Care Activities (SDSCA), the Perceived Diabetes Self-Management Scale (PDSMS), and the Adherence to Refills and Medications Scale (ARMS). Statistical analyses were conducted to explore the subscale structure of the PDQ-11, and the internal consistency and validity of its subscales. Exploratory factor analysis of the PDQ-11 revealed four components (Cronbach's α=0.50 to 0.81): Eating Behavior Problems; Use of Information for Dietary Decision Making; Calorie Restriction; and Activity and Exercise. Eating Behavior Problems and Use of Information for Dietary Decision Making had the strongest associations with the diet subscales of the SDSCA and were also correlated with the PDSMS and the ARMS scores (all ps<0.001). Different PDQ-11 subscales were correlated with BMI (Calorie Restriction Activity and Exercise) and blood pressure (Eating Behavior Problems). The PDQ-11 is a useful measure of dietary behaviors in patients with type 2 diabetes; its use may help providers tailor individual nutrition intervention strategies to patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Helicobacter pylori in Diabetic and Non-Diabetic Patients with Dyspepsia

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Mohammad Hossein Hashemi

2012-05-01

Full Text Available Helicobacter pylori (H. pylori is one of the most common chronic infections in patients with gastrointestinal disorders. Recent reports suggested that H. pylori might have high prevalence among patients with diabetes. The aim of this cross-sectional study was to assess the prevalence of H. pylori infection in diabetes mellitus and to study the relationship between histological findings and H. pylori infection in diabetic patients. Eighty patients with dyspepsia that were referred to our gastrointestinal department between May 2007 and May 2008 were included in our study. We checked fasting blood sugar for all of the study samples. All of patients underwent upper endoscopy and biopsy specimens were obtained from the antrum and the corpus. The specimens for the presence of H. pylori were colored by Giemsa stains. A single pathologist evaluated the histology slides. We found that prevalence of H. pylori infection was significantly higher in diabetics than in non-diabetics (P=0.001. Indeed, the prevalence of gastritis did differ significantly between the two groups (P=0.001. According to our results diabetes mellitus is one of the risk factor that must be considered in evaluation of H. pylori infection in diabetic patients with dyspepsia.

Evaluation of cardiovascular autonomic nervous functions in diabetics: Study in a rural teaching hospital

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Ashutosh Pathak

2017-01-01

Full Text Available Introduction: Cardiovascular autonomic neuropathy (CAN is a least understood complication of diabetes which is often underdiagnosed. It causes resting tachycardia, orthostatic hypotension, and exercise intolerance and is associated with higher cardiovascular mortality in diabetic patients. This stresses the need of early diagnosis of CAN to prevent higher mortality rates. Materials and Methods: Fifty cases of diabetes mellitus with no clinical evidence of cardiac disease were subjected to cardiac autonomic function (CAF tests according to Ewing's criteria which included heart rate (HR variability during deep breathing, Valsalva maneuver ratio, HR response on standing, blood pressure (BP response to standing, and BP response to sustained handgrip to find the prevalence of CAN. Results: In this study, among 100 patients (50 case and 50 control, we found CAN in 52%. Out of which, parasympathetic neuropathy was seen in 52% of cases, and sympathetic neuropathy was seen in 26% of cases. CAF tests of HR variability during deep breathing, Valsalva maneuver ratio, HR response to standing, BP response to standing, and BP response to sustained handgrip found abnormal response in 68%, 40%, 52%, 12%, and 14%, respectively. Diabetic retinopathy and nephropathy were significantly associated with CAN (P = 0.0001, S. Conclusion: Prevalence of CAN among diabetics was 52%, and parasympathetic CAF tests are more sensitive for the detection of CAN than sympathetic CAF tests. Development of CAN in diabetic patients may lead to increased morbidity; thence, they should be routinely evaluated for CAN using these bedside tests.

Study of the reaction γγ→3π+3π- with the JADE detector at PETRA

International Nuclear Information System (INIS)

Pust, R.

1990-03-01

The reaction γγ→3π + 3π - was studied with the JADE detector at a mean c. m. energy of 36.4 GeV and an integrated luminosity of 221 (pb) -1 . The topological cross section σ(γγ→3π + 3π - ) was measured for γγ energies between 1.5 GeV and 5.5 GeV. The cross section reaches after a steep increasing at 2 GeV a maximal value of about 5 nb and decreases above 3 GeV. The preliminary results of ARGUS and CELLO show the same slope. The values measured by ARGUS however ly systematically by some standard deviations higher. In the 3π + 3π - channel a high ρ 0 production rate was observed (in the mean 1.4 ρ 0 mesons per event). Above the kinematical ρ 0 ρ 0 π + π - threshold of about 2 GeV nearly two ρ 0 mesons per event are observed. The ρ 0 rate reaches for γγ energies between 3 and 4 GeV a minimum of 0.8 and increases above 4 GeV to 1.6. For the cross section of the reaction γγ→ρ 0 ρ 0 π + π - upper limits were determined. Because no direct hints for the resonance ρ(1700) were observed, about the reaction γγ→ρ 0 ρ(1700) no concrete statements can be made. In the events selected for the 3π + 3π - analysis the Bose-Einstein correlations of equally charged pions was observed. (orig./HSI) [de

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.

Science.gov (United States)

Vissenberg, Charlotte; Nierkens, Vera; Uitewaal, Paul J M; Geraci, Diana; Middelkoop, Barend J C; Nijpels, Giel; Stronks, Karien

2012-03-19

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. 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 participants' immediate social environments. With this

Evaluation of TGF beta1 expression and comparison the thickness of different aorta layers in experimental diabetes.

Science.gov (United States)

Cuce, G; Kalkan, S S; Esen, H H

2011-01-01

It was aimed to investigate the effects of experimental diabetes on TGF beta1 expression and tunica intima and media thickness in abdominal and thoracic aorta. Fourteen three months old female rats were divided into two groups, non-diabetic and streptozotocin (STZ) induced diabetic group. Hematoxylin-Eosin and Verhoeff's Van Gieson elastic staining and TGF beta1 immunohistochemistry staining were performed. Abdominal and thoracic intima and media thickness of aortas were measured with the oculometer. Evaluation of intima and media thickness measurements showed no significant statistical differences between non-diabetic and diabetic groups. TGF beta1 expression increased significantly in thoracic diabetic (TD) group. The 60 day duration of diabetes is not sufficiently enough time for the development of pathological changes that could lead to thickening in aortic intima-media layers. TGF beta1 expression was negative in the abdominal aorta that can predispose to the development of atherosclerosis, which could develop overtime. This finding may be interpreted as an appropriate basis for the development of atherosclerosis. In the thoracic aorta TGF beta1 may coordinate cellular events such as tissue repair (Fig. 5, Ref. 23).

Diabetic Nephropathy and Microalbuminuria in Pregnant Women With Type 1 and Type 2 Diabetes

DEFF Research Database (Denmark)

Damm, Julie Agner; Asbjörnsdóttir, Björg; Callesen, Nicoline Foged

2013-01-01

To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol....

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

Enhancing the effectiveness of diabetes self-management education: the diabetes literacy project.

Science.gov (United States)

Van den Broucke, S; Van der Zanden, G; Chang, P; Doyle, G; Levin, D; Pelikan, J; Schillinger, D; Schwarz, P; Sørensen, K; Yardley, L; Riemenschneider, H

2014-12-01

Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels. © Georg Thieme Verlag KG Stuttgart · New York.

ANTI-DIABETIC EFFECTS OF TURMERIC IN ALLOXAN INDUCE D DIABETIC RATS

OpenAIRE

Jeevangi; Manjunath; Deepak D; Prakash G; Prashant; Chetan

2013-01-01

ABSTRACT: OBJECTIVE AND BACKGROUND: Turmeric (Curcuma longa) is one of the common constituents of our daily food. The present study wa s undertaken to evaluate the anti-diabetic effects of ethanolic extract of Rhizomes of curcuma longa in alloxan induced diabetic rats and compared with of Pioglitazone, which is the standard anti-diabetic agent. METHODS: Alloxan monohydrate is used to induce diabetes mellitus in albino rats in the dose of 120mg/kg i.p. and ...

Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

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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.

Evaluation of a Diabetes Coach Program Aimed to Improve the Care of Children and Youth With Type 1 Diabetes and With Compromised Control.

Science.gov (United States)

Luca, Paola; Haugrud, Bodiel; Husband, Allison; Dawrant, Jonathan; Pacaud, Danièle

2018-01-31

To evaluate the impact of the Diabetes Coach Program (DCP) on glycated hemoglobin (A1C) levels in youth with type 1 diabetes. The youth were referred to and participated in the DCP between October 2011 and May 2016. The Diabetes Coach visited families in their homes every 1 to 2 weeks and updated patients' diabetes teams regularly. A1C levels before the DCP were compared with A1C levels during and after discharge from the DCP. Six participating families completed satisfaction surveys via telephone. The DCP included 23 participants (43% male; median age, 11 years; range, 8.8 to 14.5 years); median duration of type 1 diabetes, 1.7 years (range, 0.1 to 6.3 years); median time in the DCP, 1.5 years (range, 0.2 to 2.5 years). During involvement in the program, median A1C levels decreased from baselines of 11.1% (range, 8.9% to 15.3%) to 10.2% (range, 7.6% to 12.4%) (p=0.0028). For 11 of 13 patients discharged from the DCP, the most recent median A1C levels, 11.2% (range, 9.1% to 13.6%), an average of 2.4 years later, were not different from the initial A1C levels (p=0.85). Family feedback was overwhelmingly positive. Participation in the DCP decreased A1C values in pediatric patients; however, the levels were not sustained after visits stopped. Pediatric health coaches may play an important role in the management of type 1 diabetes, but further research is needed to explore their benefits and how positive effects can be sustained. Copyright © 2018 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

GFR, serum creatinine and 24-hour urine protein in evaluating renal function of patients with diabetes mellitus

International Nuclear Information System (INIS)

Chi Xiaohua; Li Guiping; Liu Feng; Wang Bing; Du Li; Deng Zhifang; Li Wei

2013-01-01

Background: Diabetes nephropathy is a common complication of diabetes mellitus patients. Early detection of renal impairment can improve the quality of life of patients. Purpose: The value of total GFR, serum creatinine, 24-hour urine protein excretion in diabetes mellitus patients with renal impairment were evaluated. Methods: A retrospective analysis of 147 patients with diabetes undergoing routine renal dynamic imaging was undertaken. The cases were divided into three groups according to the illness duration: group I of not more than five years, group 2 of five to ten years, Gr.3: more than ten years. The 22 renal transplant donors were selected as the normal control group, The total GFR, serum creatinine and 24-hour urinary protein excretion of all patients were measured before the treatments, and the data were statistically analyzed. Results: There was no significant differences in renal function between the two kidneys of in the diabetes mellitus patients (P=0.536). Serum creatinine and total GFR had significant correlation (R 2 =0.762), but no significant relationship between the 24-hour urine protein and the total GFR or serum creatinine. In the early and middle times of renal function impairment, the total GFR and serum creatinine have significant difference in different time periods (P<0.05). During the mid-late times of renal function impairment, total GFR and serum creatinine have no statistically significant differences (P value is 0.781, 0.297). 24-hour urine protein quality had no statistical differences in each stage. However: the total GFR is more sensitive than the serum creatinine in evaluation of early impairing of renal function. Conclusions: There is significant correlation between serum creatinine and total GFR. Both of them can reflect the degree of diabetic renal injury, but the total GFR is more sensitive than serum creatinine in early degree. 24-hour urine protein quantitative can not evaluate the degree of impaired renal function alone

Comparison of the clinical parameters of benign prostate hyperplasia in diabetic and non diabetic patients

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Levent Ozcan

2017-03-01

Full Text Available Objective: We evaluated the correlation between benign prostate hyperplasia (BPH measures and diabetes mellitus in men with benign prostate hyperplasia in a prospective study. Materials and methods: Between 2008-2012, 100 diabetic and 200 non diabetic patients undergoing surgery due to benign prostate hyperplasia were enrolled in the study. The parameters evaluated for each patients included prostate volume, fasting blood glucose, HbA1c, total testosterone, total prostatic specific antigen (T-PSA, triglicerides, total cholesterol and body mass index (BMI. A questionnaire including international prostate symptom score (IPSS was sdministered and uroflow test measuring the peak urinary flow rate was performed to appreciate the complaints of the patients objectively. Results: Diabetic patients are more likely to have larger prostate volume. The symptom score evaluated by IPSS and post micturition residual volume were also significantly higher in diabetic groups. The other statistically significant different parameter between two groups was total testosterone that diabetic patients tend to have lower levels. Diabetic counterparts were established to have higher BMI. No statistically significant differentiation was observed about trigliceryde and total cholesterol levels and uroflow rates. Conclusions: Our study suggests a positive correlation between high prostate volume and diagnosis of diabetes mellitus in patients with benign prostatic hyperplasia. We also observed a positive correlation between symptom scores and post micturion residual volumes and diagnosis of diabetes mellitus suggesting that the presence of diabetes is related to both static and dynamic components of benign prostate hyperplasia. Additionally testosterone levels were lower in diabetic patients. Further studies need to confirm these relationship in a larger population.

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

Monogenic diabetes is a genetic disease often caused by mutations in genes involved in beta-cell function. Correct sub-categorization of the disease is a prerequisite for appropriate treatment and genetic counseling. Target-region capture sequencing is a combination of genomic region enrichment...... 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...

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

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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.

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

Measurement of the 2-photon production of ρ0ω with the JADE detector at PETRA

International Nuclear Information System (INIS)

Wegner, A.

1990-03-01

With the JADE detector the 2-photon production of the vector-meson pair ωρ 0 was studied. The measurement with an integrated luminosity of 224 (pb) -1 was performed at a mean beam energy of 18 GeV. Both the cross section σsub(γγ→ωπ + π - ) in dependence on the γγ c.m. energy W γγ and for W γγ >1.5 GeV the contribution with intermediate ρ 0 production to this cross section were determined. For smaller γγ energies no ρ 0 contribution could be determined, because this range lies below the threshold for ωρ 0 and no from the phase space distinguishable ρ 0 signal in the invariant π + π - mass occurs. But in this range the measured cross section σsub(γγ→ωπ + π - ) is extensively exhausted by the expected contribution of the reaction γγ→a 2 (1320)→ωπ + π - . The increase of the cross section σsub(γγ→ωπ + π - ) indicated by ARGUS and TPC/γγ in the W γγ range around 1.9 GeV cannot be confirmed in this measurement. In this range the cross section measured in this analysis lies significantly below the measurements of these experiments, while in the remaining W γγ range all three measurements agree within the errors. The comparison of the measured cross section with the t-channel factorization model and the qanti qqanti q model shows that both models are able to describe the data. The increase of the cross section around 1.9 GeV in the measurements of ARGUS and TPC/γγ however leads to discrepancies in comparison to these models. (orig.) [de

Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients.

Science.gov (United States)

Poulimeneas, Dimitrios; Grammatikopoulou, Maria G; Bougioukli, Vasiliki; Iosifidou, Parthena; Vasiloglou, Maria F; Gerama, Maria-Assimina; Mitsos, Dimitrios; Chrysanthakopoulou, Ioanna; Tsigga, Maria; Kazakos, Kyriakos

2016-01-01

Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients' medical files. Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

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

Home-Based Diabetes Symptom Self-Management Education for Mexican Americans with Type 2 Diabetes

Science.gov (United States)

García, Alexandra A.; Brown, Sharon A.; Horner, Sharon D.; Zuñiga, Julie; Arheart, Kristopher L.

2015-01-01

This pilot study evaluated an innovative diabetes symptom awareness and self-management educational program for Mexican Americans, a fast growing minority population experiencing a diabetes epidemic. Patients with diabetes need assistance interpreting and managing symptoms, which are often annoying and potentially life-threatening. A repeated…

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

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......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...

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.

Glomerular size- and charge selectivity in type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy

DEFF Research Database (Denmark)

Gall, M A; Rossing, P; Kofoed-Enevoldsen, A

1994-01-01

In an attempt to evaluate the mechanisms of proteinuria in diabetic kidney disease, we measured the renal clearances of albumin, total IgG, and IgG4 in 20 male Type 2 (non-insulin-dependent) diabetic patients with diabetic glomerulosclerosis (biopsy proven), in 10 male Type 2 diabetic patients...

Dietary fish oil supplements increase tissue n-3 fatty acid composition and expression of delta-6 desaturase and elongase-2 in Jade Tiger hybrid abalone.

Science.gov (United States)

Mateos, Hintsa T; Lewandowski, Paul A; Su, Xiao Q

2011-08-01

This study was conducted to investigate the effects of fish oil (FO) supplements on fatty acid composition and the expression of ∆6 desaturase and elongase 2 genes in Jade Tiger abalone. Five test diets were formulated to contain 0.5, 1.0, 1.5, 2.0 and 2.5% of FO respectively, and the control diet was the normal commercial abalone diet with no additional FO supplement. The muscle, gonad and digestive glands (DG) of abalone fed with all of the five test diets showed significantly high levels of total n-3 polyunsaturated fatty acid (PUFA), eicosapentaenoic acid (EPA), docosapentaenoic acid n-3 (DPAn-3), and docosahexaenoic acid (DHA) than the control group. In all three types of tissue, abalone fed diet supplemented with 1.5% FO showed the highest level of these fatty acids (P abalone fed diet supplemented with 2% FO (P abalone fed diet supplemented with 1.5% FO (P abalone fed with diet containing 0.5% FO supplement (P abalone, with 1.5% being the most effective supplementation level.

Diabetes Distress Among Persons With Type 1 Diabetes.

Science.gov (United States)

Powers, Margaret A; Richter, Sara A; Ackard, Diann M; Craft, Cheryl

2017-02-01

Purpose The purpose of this study is to evaluate associations between diabetes distress and a range of psychological health behaviors and concerns among persons with type 1 diabetes for the benefit of enhancing early identification and intervention of at-risk individuals. Methods Persons with type 1 diabetes (n = 268; 57.1% female, 91.0% white, 76.8% satisfaction with life, self-esteem, self-efficacy, depression, perfectionism, body image satisfaction, dietary restraint and eating, and shape and weight concerns. Each subscale score was compared within age groups (depression scores and eating, and shape and weight concerns than those with low or moderate distress. For patients satisfaction with life, self-esteem, and self-efficacy and higher on dietary restraint and several areas of perfectionism than those with low or moderate distress. Conclusions Individuals with type 1 diabetes who have high diabetes distress also report higher A1C values and poorer psychological health concerns. A brief diabetes distress questionnaire can help to identify those who need additional screening, education and support, and treatment for overall health and well-being.

Pregnancy-induced increase in circulating IGF-I is associated with progression of diabetic retinopathy in women with type 1 diabetes

DEFF Research Database (Denmark)

Nielsen, Lene Ringholm; Vestgaard, Marianne; Laugesen, Caroline S

2011-01-01

To evaluate the influence of Insulin-like Growth factor-I (IGF-I) and Placental Growth Hormone (GH) on progression of diabetic retinopathy during pregnancy in women with type 1 diabetes.......To evaluate the influence of Insulin-like Growth factor-I (IGF-I) and Placental Growth Hormone (GH) on progression of diabetic retinopathy during pregnancy in women with type 1 diabetes....

Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

Science.gov (United States)

Arnold, Pamela; Scheurer, Danielle; Dake, Andrew W; Hedgpeth, Angela; Hutto, Amy; Colquitt, Caroline; Hermayer, Kathie L

2016-04-01

The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Published by Elsevier Inc.

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.

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

Evaluation of dermal myelinated nerve fibers in diabetes mellitus

Science.gov (United States)

Peltier, Amanda C.; Myers, M. Iliza; Artibee, Kay J.; Hamilton, Audra D.; Yan, Qing; Guo, Jiasong; Shi, Yaping; Wang, Lily; Li, Jun

2013-01-01

Skin biopsies have primarily been used to study the non-myelinated nerve fibers of the epidermis in a variety of neuropathies. In the present study, we have expanded the skin biopsy technique to glabrous, non-hairy skin to evaluate myelinated nerve fibers in the most highly prevalent peripheral nerve disease, diabetic polyneuropathy (DPN). Twenty patients with DPN (Type I, n=9; Type II, n=11) and sixteen age-matched healthy controls (ages 29–73) underwent skin biopsy of the index finger, nerve conduction studies, and composite neuropathy scoring. In patients with DPN, we found a statistically significant reduction of both mechanoreceptive Meissner corpuscles (MC) and their afferent myelinated nerve fibers (p=0.01). This myelinated nerve fiber loss was correlated with the decreased amplitudes of sensory/motor responses in nerve conduction studies. This study supports the utilization of skin biopsy to quantitatively evaluate axonal loss of myelinated nerve fibers in patients with DPN. PMID:23781963

Diabetes øger risikoen for frakturer

DEFF Research Database (Denmark)

Starup-Linde, Jakob; Karahasanovic, Azra; Vestergaard, Peter

2016-01-01

Diabetes is associated with an increased risk of fracture, however, neither bone mineral density, falls, diabetes complications nor other risk factors can explain why. Among patients with diabetes, hyperglycaemia may have detrimental effects on bone, but also use of anti-diabetic treatment may have...... an impact on fracture risk. In this article we assess the relationship between diabetes, bone and fracture and the effects of hyperglycaemia and anti-diabetic treatment on bone. Furthermore, fracture preventive measures in patients with diabetes are evaluated....

Diabetes øger risikoen for frakturer

DEFF Research Database (Denmark)

Starup-Linde, Jakob; Karahasanovic, Azra; Vestergaard, Peter

2015-01-01

Diabetes is associated with an increased risk of fracture, however, neither bone mineral density, falls, diabetes complications nor other risk factors can explain why. Among patients with diabetes, hyperglycaemia may have detrimental effects on bone, but also use of anti-diabetic treatment may have...... an impact on fracture risk. In this article we assess the relationship between diabetes, bone and fracture and the effects of hyperglycaemia and anti-diabetic treatment on bone. Furthermore, fracture preventive measures in patients with diabetes are evaluated....

Evaluation of the Hypoglycaemic Activity of Petiveria alliacea (Guinea Hen Weed) Extracts in Normoglycaemic and Diabetic Rat Models.

Science.gov (United States)

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.

Knowledge of diabetic complications in patients with diabetes mellitus

International Nuclear Information System (INIS)

Ullah, F.; Afridi, A.K.; Rahim, F.; Ashfaq, M.; Khan, S.

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. Methods: This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Results: Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 ± 10.821 years while the mean duration of diabetes mellitus was 9.75 ± 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Conclusions: Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus. (author)

KNOWLEDGE OF DIABETIC COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS.

Science.gov (United States)

Ullah, Fahim; Afridi, Ayesha Khan; Rahim, Fawad; Ashfaq, Muhammad; Khan, Sheema; Shabbier, Ghulam; Rahman, Sadiq Ur

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 +/- 10.821 years while the mean duration of diabetes mellitus was 9.75 +/- 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus.

Hypoglycemia evaluation and reporting in diabetes: Importance for the development of new therapies.

Science.gov (United States)

Klonoff, David C; Alexander Fleming, G; Muchmore, Douglas B; Frier, Brian M

2017-07-01

Hypoglycemia complicating diabetes therapy is well recognized to be an ever-present threat to patients, their families, providers, payers, and regulators. Despite this being widely acknowledged, the regulatory stance on hypoglycemia as an endpoint in clinical trials to support new product registration has not evolved in any meaningful way since the publication of a position paper by an American Diabetes Association (ADA) Workgroup in 2005. As the impact of hypoglycemia on persons affected by diabetes is of major importance when assessing new treatments, the historical position of regulatory agencies on hypoglycemia is reviewed with respect to product approvals. The purpose of this article is to present proposals for facilitating development of therapies that reduce hypoglycemia risk through (1) development of composite measures of benefit for regulatory endpoints and (2) facilitation of the fulfillment of an unmet clinical need for reducing hypoglycemia. In view of greater comprehension of the effects of hypoglycemia, coupled with improved methodology to assess its frequency, the authors recommend: (1) a numerical cut point of <54 mg/dl (<3.0 mmol/L) as a clinically relevant level with which to define meaningful hypoglycemia for trials of diabetes therapies; (2) utilization in clinical trials of mature glucose monitoring technologies for purposes of regulatory evaluation and clinical decision-making; and (3) development of primary efficacy endpoint composites that include hypoglycemia rates and glycemic control. Copyright © 2017 John Wiley & Sons, Ltd.

Comprehensive Evaluation of Anti-hyperglycemic Activity of Fractionated Momordica charantia Seed Extract in Alloxan-Induced Diabetic Rats

Directory of Open Access Journals (Sweden)

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.

Comprehensive Evaluation of Anti-hyperglycemic Activity of Fractionated Momordica charantia Seed Extract in Alloxan-Induced Diabetic Rats

Science.gov (United States)

Choudhary, Shailesh Kumar; Chhabra, Gagan; Sharma, Dipali; Vashishta, Aruna; Ohri, Sujata; Dixit, Aparna

2012-01-01

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. PMID:23320026

EVALUATION OF DIABETIC MACULAR OEDEMA WITH SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND FUNDUS FLUORESCEIN ANGIOGRAPHY

Directory of Open Access Journals (Sweden)

Mallika Venkitasubramanian

2017-02-01

Full Text Available BACKGROUND Macular oedema is an important cause of visual morbidity in Diabetic Retinopathy. It can be assessed by both Fundus Fluorescein Angiography (FFA and Optical Coherence Tomography (OCT. The aims of this study were to evaluate the agreement between morphological features on spectral domain Optical Coherence Tomography and Fluorescein Angiographic leakage patterns in Diabetic Macular Oedema, and to study the correlation between the best corrected visual acuity and central foveal thickness measured by Optical Coherence Tomography. MATERIALS AND METHODS This was an observational study. All patients with Diabetic Macular Oedema underwent complete ophthalmic examination and subjected to FFA and OCT. Presence or absence of macular oedema by FFA and OCT was noted and agreement between two modalities of imaging was assessed. Sensitivity of these modalities were also found out using appropriate statistical methods. Best Corrected Visual Acuity (BCVA measured were converted to LogMAR scale and Central foveal thickness measured by OCT. Linear regression analysis was done with central foveal thickness and LogMAR visual acuity. RESULTS A total of 69 eyes of 39 patients were studied. OCT revealed Diabetic Macular Oedema in 97.5% of eyes. Fundus Fluorescein Angiography performed in these patients identified leakage in 95.6% of eyes. Sensitivity and specificity of FFA and OCT were calculated keeping one as the gold standard for sensitivity and specificity of the other. FFA and OCT had almost equal sensitivity (95.46 for OCT and 96.92 for FFA for detection of DME. Specificity of OCT was found to be slightly higher (33.33% compared to FFA (25%. Our results suggest that there is minimal agreement between these two imaging modalities in evaluating DME. Statistically, Kappa value was 0.248. Linear regression analysis showed that central foveal thickness had a significant correlation with visual acuity, with Pearson correlation coefficient r=0.442, p=0

[The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

Science.gov (United States)

Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

2012-08-01

Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New

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

Contemporary Evaluation and Management of the Diabetic Foot

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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

Intimal permeability evaluated in a short-term organ culture of diabetic guinea pig aorta

International Nuclear Information System (INIS)

Schlosser, M.J.; Verlangieri, A.J.

1988-01-01

A novel short-term organ culture system was used to evaluate intimal permeability changes by measuring aortic [ 14 C]methylated albumin accumulation. Aortic plugs were removed from the upper thoracic aorta of male guinea pigs and maintained in serum-free media. The accumulation of [ 14 C]albumin in the intimal-medial layer was determined after a 5 h incubation. In preliminary studies, albumin recovered from intimal-injured aortic plugs was significantly greater than those from non-injured plugs. Aortic plugs from streptozotocin-treated guinea pigs, diabetic for 3 weeks, also accumulated significantly more [ 14 C]albumin than plugs from nondiabetic controls. Histological changes were not observed in the aorta of either the diabetic or control group. A strong significant inverse correlation was found between plasma ascorbic acid levels and [ 14 C]-activity recovered from aortic plugs. This study demonstrates a simple and rapid method for assessing aortic permeability changes under a well-defined in vitro system, and suggests that vascular permeability changes in the streptozotocin-diabetic guinea pig may be associated with an ascorbic acid deficit

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

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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

Elevated vascular endothelial growth factor in type 1 diabetic patients with diabetic nephropathy

DEFF Research Database (Denmark)

Hovind, P; Tarnow, L; Oestergaard, P B

2000-01-01

patients with and without proliferative retinopathy were detected. CONCLUSIONS: Our data suggest that VEGF is elevated early in the course of diabetic nephropathy in men with type 1 diabetes mellitus. Baseline albuminuria, arterial blood pressure and male gender was predictors of diabetic nephropathy......BACKGROUND: Growth factors have been suggested to play a role in the development and progression of diabetic nephropathy. Vascular endothelial growth factor (VEGF) is a potent cytokine family that induces angiogenesis and markedly increases endothelial permeability. The aim of the present study...... was to investigate plasma levels of VEGF in a large cohort of type 1 diabetic patients with diabetic nephropathy and in long-standing type 1 diabetic patients with persistent normoalbuminuria, and to evaluate VEGF as a predictor of nephropathy progression. METHODS: We measured VEGF with an enzyme...

Preventing progression from gestational diabetes mellitus to diabetes: A thought-filled review.

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Kasher-Meron, Michal; Grajower, Martin M

2017-10-01

Women with a history of gestational diabetes are at high risk for developing type 2 diabetes mellitus. In studies with long periods of follow-up, diabetes incidence of up to 70% has been reported. The appropriate follow-up of women following a pregnancy complicated by gestational diabetes has not been studied. Published guidelines recommend that obstetrician/gynaecologists, who are often the de facto primary care physicians for these otherwise healthy young women, incorporate glucose monitoring in the post-partum period into their annual examinations. In reality, reported rates of screening have been low. There is also no clear evidence for any beneficial interventions to prevent diabetes in patients with prior history of gestational diabetes. Lifestyle intervention programmes for diabetes prevention among these patients yielded disappointing results. Metformin, pioglitazone, liraglutide, and bariatric surgery are possible options but based on inadequate data. There remains a need for randomized, placebo-controlled studies to evaluate various pharmacologic treatments, with and without lifestyle interventions, to prevent type 2 diabetes mellitus in women with a history of gestational diabetes. Copyright © 2017 John Wiley & Sons, Ltd.

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

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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

2018-05-01

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.

Depressive symptoms in youth with type 1 or type 2 diabetes: Results of the Pediatric Diabetes Consortium screening assessment of depression in diabetes study

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To evaluate the frequency of depressive symptoms and the diagnosis and management of depression in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium T1D and T2D registries. The Children's Depression Inventory (CDI) 2 Self-Report (Short) version ...

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

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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.

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

LENUS (Irish Health Repository)

Egan, Aoife M

2017-04-01

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.

Menopause and risk of diabetes in the Diabetes Prevention Program.

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Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

2011-08-01

The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

Outcome of Diabetic and Non-Diabetic Patients Undergoing Successful Percutaneous Coronary Intervention of Chronic Total Occlusion

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Bahram Sohrabi

2011-05-01

Full Text Available Introduction: Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention (PCI. The prognosis of patients with diabetes mellitus and chronic total occlusion (CTO treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. Methods: One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15±3 months, were evaluated for the occurrence of major adverse cardiac events (MACE comprising death, acute myocardial infarction, and need for repeat revascularization.Results: No differences were found in baseline clinical and procedural variables between patients with (n=34 and without diabetes (n=129, unless for hypertension (p=0.03. Hospitalization period after PCI in diabetics (3.26±0.61 days and non-diabetics (2.86±0.52 days was similar. In-hospital MACE occurred in 8 (23.5% individuals of diabetics and 10 (7.8% individuals of non-diabetics (p=0.02, among them revascularization was significantly higher in diabetics (20.6% vs. 7%, p=0.04. Follow-up events in diabetic and non-diabetic groups were 12 (35.3% and 37 (28.5%, respectively (p was not significant. Conclusion: In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients.

Jiangtang Xiaozhi Recipe () prevents diabetic retinopathy in streptozotocin-induced diabetic rats.

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Li, Lin; Li, Yan-Lin; Zhou, Yun-Feng; Ge, Zheng-Yan; Wang, Li-Li; Li, Zhi-Qiang; Guo, Yu-Jie; Jin, Long; Ren, Ye; Liu, Jian-Xun; Xu, Yang

2017-06-01

To evaluate the prevention effect of diabetic retinopathy of Jiangtang Xiaozhi Recipe (, JXR) in streptozotocin (STZ)-induced diabetic rats. Sprague-Dawley rats were randomly divided into normal control group and diabetic group. Rats in the diabetic group were induced by intraperitoneal administration of STZ (50 mg/kg), and subdivided into 5 groups. Rats in the diabetic control group were given saline; four treatment groups were given metformin (300 mg/kg), JXR (2, 4 and 8 g/kg) respectively for 8 weeks, while rats in the normal control group were injected with citrate buffer and given the same volume of vehicle. Body weight and food intake were measured every week. The hypoglycaemic effects were determined by testing fasting blood glucose (FBG) every other week, and hemoglobin A1c (HbA1c), insulin, and glucagon at the end of the treatment. The preventive effects of JXR on STZ-induced diabetic rats were determined by histopathological examination with hematoxylin and eosin staining, and periodic acid-schiff staining. The effects were further evaluated by serum superoxide dismutase (SOD) activity and malondialdehyde (MDA). High-dose JXR significantly reduced FBG and HbA1c level at the 8th week of administration (Pdiabetic rats. Histopathological studies revealed that there were no basement membrane thickening and mild destruction in the treated groups. Morphometric measurements of retina microvascular showed that acellular capillary and capillary density decreased in treated rats while pericyte and endothelial cell increasing after the treatment. JXR have protective effect of diabetic retinopathy and its mechanism may be associated with the obvious hypoglycemic and antioxidant effect.

Off-loading strategies in diabetic foot syndrome-evaluation of different devices.

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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.

Evaluation of cardiac risk by oxidative stress and inflammatory markers in diabetic patients

International Nuclear Information System (INIS)

Khan, D.A.; Qayyum, S.

2010-01-01

Objectives: To evaluate the diabetic patients for cardiac risk by measuring oxidative stress and inflammatory markers in relation with glycaemic control. Methodology: A total of 140 subjects were included in this case-control study, comprising of 70 diabetic patients with coronary heart disease (CHD) and an equal number, age and sex matched controls. The patients were non-alcoholic and had age >40 years, BMI < 30 kg/m/sup 2/ and glycated hemoglobin (HbA1c) 7-10%. Serum total cholesterol (TC) and gamma glutamyltransferase (GGT) were analyzed on selectra-E auto analyzer. Serum nitrate was measured at 540 nm on ELISA. HbA1c on was analyzed by using Human kit. Serum high sensitivity C-reactive protein (hS-CRP) was analyzed on immulite 1000. Results: Patients mean age was 51 (range 40-73) years. Diabetic patients had significantly elevated median of HbA1c (7.9 vs 4.9), hS CRP (6.0 vs 2.12), TC (5.95 vs 4.45), nitrate (19.20vs 10.70) and GGT (29.50 vs 22.50) as compared to controls (p< 0.001). HbA1c showed a positive correlation (p <0.001) with hS-CRP (r=0.49), TC (r=0.69), nitrate (r=0.41) and GGT (r=0.30). Conclusion: Oxidative stress and inflammatory markers should be used in addition to HbA1c for assessment of increased cardiac risk in un-controlled diabetic patients because of accelerated atherosclerosis due to free radical injury. (author)

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

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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.

Higher mortality of patients on haemodialysis with pancreatic diabetes compared to type 2-diabetes

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Bodlaj Gert

2012-03-01

Full Text Available Abstract In rare cases (1-8% diabetic patients with end-stage renal disease (ESRD suffer from diabetic nephropathy (dNP due to pancreatic diabetes mellitus (PDM. Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes. In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD in our dialysis centre (1997-2005. In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups. The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m2 was lower (22 + 3 versus 25 + 3, and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status.

Monitoring of Individual Needs in Diabetes (MIND)-2

DEFF Research Database (Denmark)

Snoek, Frank J; Kersch, Nancy Y A; Eldrup, Ebbe

2012-01-01

To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences.......To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences....

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…

Developing Community Health Worker Diabetes Training

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Ferguson, W. J.; Lemay, C. A.; Hargraves, J. L.; Gorodetsky, T.; Calista, J.

2012-01-01

We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included…

Insulin requirements in type 1 diabetic pregnancy

DEFF Research Database (Denmark)

Callesen, Nicoline; Ringholm, Lene; Stage, Edna

2012-01-01

To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy.......To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy....

Non-diabetic renal disease in patients with type-2 diabetes mellitus

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Sonia Yaqub

2012-01-01

Full Text Available Diabetic nephropathy (DN is the leading cause of end-stage renal disease in diabetics worldwide, yet most patients with type-2 diabetes mellitus are not formally evaluated with a renal biopsy. The diagnosis is almost always based on clinical grounds. A wide spectrum of non-diabetic renal disease (NDRD is reported to occur in patients with type-2 diabetes. It has been estimated that up to one-third of all diabetic patients who present with proteinuria are suffering from NDRD. The aim of this analysis was to evaluate the prevalence and etiology of NDRD in patients with type-2 diabetes. We retrospectively reviewed the medical records of patients with type-2 diabetes who underwent kidney biopsy on clinical suspicion of NDRD (absence of diabetic retinopathy and/or neuropathy; short duration of diabetes, i.e. less than five years from January 2003 through December 2007 at the Aga Khan University Hospital, Karachi. Based on the biopsy findings, patients were grouped as Group-I, isolated NDRD; Group-II, NDRD with underlying DN; and Group-III, isolated DN. Of 68 patients studied, 75% were males and the mean age was 56 years. The mean duration of diabetes was nine years. Group-I included 34 patients (52%, Group-II included 11 patients (17% and Group-III included 23 patients (31%. Among the Group-I patients, the mean age was 56 years (41-77 years. The most common NDRDs were acute interstitial nephritis (32%, diffuse proliferative glomerulonephritis (17%; membranous nephropathy (12% and crescentic glomerulonephritis (12%. Among Group-II, the mean age was 60 years (46-71 years, and the most common lesion was interstitial nephritis superimposed on underlying DN (63% cases. Among Group-III, the mean age was 53 years (42- 80 years. The mean proteinuria was 5, 6.3 and 7.3 g/24 h of urine collection in Groups I, II and III, respectively (P = NS. The mean duration of diabetes was 7.3, 11.7 and 10.7 years in Groups I, II and III, respectively. The duration of

Delivering early care in diabetes evaluation (DECIDE: a protocol for a randomised controlled trial to assess hospital versus home management at diagnosis in childhood diabetes

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Robling Michael

2011-01-01

qualitative outcome measures include the experience of both approaches by a subgroup of participants (n = 30 and health professionals. Total health service costs will be evaluated. A cost effectiveness analysis will assess direct and indirect health service costs against the primary outcome (HbA1c. Discussion This will be the first randomised controlled trial to evaluate hospital and home management of children newly diagnosed with type 1 diabetes and the findings should provide important evidence to inform practice and national guidelines. Trial registration number ISRCTN: ISRCTN78114042

Noninvasive and invasive evaluation of cardiac dysfunction in experimental diabetes in rodents

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Salemi Vera

2007-04-01

Full Text Available Abstract Background Because cardiomyopathy is the leading cause of death in diabetic patients, the determination of myocardial function in diabetes mellitus is essential. In the present study, we provide an integrated approach, using noninvasive echocardiography and invasive hemodynamics to assess early changes in myocardial function of diabetic rats. Methods Diabetes was induced by streptozotocin injection (STZ, 50 mg/kg. After 30 days, echocardiography (noninvasive at rest and invasive left ventricular (LV cannulation at rest, during and after volume overload, were performed in diabetic (D, N = 7 and control rats (C, N = 7. The Student t test was performed to compare metabolic and echocardiographic differences between groups at 30 days. ANOVA was used to compare LV invasive measurements, followed by the Student-Newman-Keuls test. Differences were considered significant at P Results Diabetes impaired LV systolic function expressed by reduced fractional shortening, ejection fraction, and velocity of circumferential fiber shortening compared with that in the control group. The diabetic LV diastolic dysfunction was evidenced by diminished E-waves and increased A-waves and isovolumic relaxation time. The myocardial performance index was greater in diabetic compared with control rats, indicating impairment in diastolic and systolic function. The LV systolic pressure was reduced and the LV end-diastolic pressure was increased at rest in diabetic rats. The volume overload increased LVEDP in both groups, while LVEDP remained increased after volume overload only in diabetic rats. Conclusion These results suggest that STZ-diabetes induces systolic and diastolic dysfunction at rest, and reduces the capacity for cardiac adjustment to volume overload. In addition, it was also demonstrated that rodent echocardiography can be a useful, clinically relevant tool for the study of initial diabetic cardiomyopathy manifestations in asymptomatic patients.

Evaluation of a mobile social networking application for improving diabetes Type 2 knowledge: an intervention study using WhatsApp.

Science.gov (United States)

Turki, Alanzi; Sulaiman, Bah; Sara, Alzahrani; Sirah, Alshammari; Fatima, Almunsef

2018-06-26

The aim of this study is to evaluate the WhatsApp social networking application for improving knowledge, self-efficacy and awareness about diabetes management. The study was conducted with intervention and control groups at Teaching Hospital in Al-Khobar, Saudi Arabia. The intervention group received weekly educational messages using WhatsApp, while the control group received regular care. Statistically, compared with the control group, the diabetes knowledge and self-efficacy of the intervention group increased significantly after the intervention with the WhatsApp application. The WhatsApp application can be effectively used for enhancing diabetes knowledge, self-efficacy and awareness among the Saudi population.

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.

Histopathological and behavioral evaluations of the effects of crocin, safranal and insulin on diabetic peripheral neuropathy in rats

Directory of Open Access Journals (Sweden)

Amir Farshid

2015-08-01

Full Text Available Objectives: Crocin and safranal, the major constituents of saffron, exert neuroprotective effects. In the present study, we investigated the effects of crocin and safranal  (alone or in combination with insulin on peripheral neuropathy in diabetic rats. Materials and Methods: Diabetes was induced by intraperitoneal (i.p. injection of 60 mg/kg of streptozotocin (STZ and confirmed by blood glucose level higher than 250 mg/dl. After confirmation of diabetes, crocin (30 mg/kg, i.p., safranal (1 mg/kg, i.p. (alone or in combination with insulin and insulin (5 IU/kg, s.c. were administered for eight weeks. Neuropathic pain was evaluated using acetone drop test. Histopathological changes of sciatic nerve were evaluated using light microscope. Blood glucose levels and sciatic nerve malondialdehyde (MDA contents were also measured. Results: STZ caused cold allodynia, edema and degenerative changes of sciatic nerve, hyperglycemia and an elevation of sciatic nerve MDA levels. Crocin, safranal and insulin improved STZ-induced behavioral, histopathological and biochemical changes. Combined treatments produced more documented improving effects. Conclusion: The results of the present study showed neuroprotective effects of crocin, safranal and insulin in a rat model of diabetic neuropathy. In addition, crocin and safranal enhanced the neuroprotective effect of insulin. The neuroprotective effects of theses chemical compounds could be associated with their anti-hyperglycemic and antioxidant properties.

Anti-diabetic effects of Sargassum oligocystum on Streptozotocin- induced diabetic rat

Directory of Open Access Journals (Sweden)

Samad Akbarzadeh

2018-03-01

Full Text Available Objective(s: Diabetes is a metabolic syndrome which is associated with the worldwide major public health problems. There are many natural compounds from the sea-market, as a valuable aquatic source, along with the variety of health and therapeutic benefits. In the present research, with respect to the traditional and ethnic uses of Sargassum oligocystum algae for healing of some diseases which have similar metabolic mechanism to the diabetes, its anti-diabetic effects in animal model was proposed. Materials and Methods: The animals (rat were divided into the normal control, diabetic control, positive control and, the test groups. The test groups were gavaged with oral doses of 150 and 300 mg/kg of algae hydroalcoholic extracts. After 30 days of intervention the serum glucose, cholesterol, triglyceride, HDLC, LDLC, insulin, insulin resistance, β-cells function and, the histopathology of pancreatic tissue were evaluated. Results: In animals that were fed with algae extracts a significant decrease in the fasting blood glucose, triglyceride and HOMA-IR and an increase in the HOMA-B with no significant impacts on the insulin, cholesterol and HDL were observed. Also, the histopathology evaluations in the groups which were treated with algae extract revealed the regeneration and reconstitution of damaged pancreatic β-cells. Conclusion: The results give evidence that, the S. oligocystum algae extract has a healing effect on diabetes which can be considered as a new research prospect for the natural therapy of diabetes.

Diabetic retinopathy in pregnancy: a population-based study of women with pregestational diabetes.

LENUS (Irish Health Repository)

Egan, Aoife M

2015-04-01

The aim of this observational study was to evaluate screening and progression of diabetic retinopathy during pregnancy in women with pregestational diabetes attending five antenatal centres along the Irish Atlantic seaboard. An adequate frequency of screening was defined as at least two retinal evaluations in separate trimesters. Progression was defined as at least one stage of deterioration of diabetic retinopathy and\\/or development of diabetic macular edema on at least one eye. Women with pregestational diabetes who delivered after 22 gestational weeks (n = 307) were included. In total, 185 (60.3%) had an adequate number of retinal examinations. Attendance at prepregnancy care was associated with receiving adequate screening (odds ratio 6.23; CI 3.39-11.46 (P < 0.001)). Among those who received adequate evaluations (n = 185), 48 (25.9%) had retinopathy progression. Increasing booking systolic blood pressure (OR 1.03, CI 1.01-1.06, P = 0.02) and greater drop in HbA1c between first and third trimesters of pregnancy (OR 2.05, CI 1.09-3.87, P = 0.03) significantly increased the odds of progression. A significant proportion of women continue to demonstrate retinopathy progression during pregnancy. This study highlights the role of prepregnancy care and the importance of close monitoring during pregnancy and identifies those patients at the highest risk for retinopathy progression.

Evaluation of blood glucose and thyroid function in Sudanese diabetic patients

International Nuclear Information System (INIS)

Agarib, M.O.A.

2008-03-01

This study composes of two parts. The first one is a survey of thyroid abnormalities, and the second one is experiment to estimate the level of thyroid hormones (T 4 , T 3 , TSH) among diabetic population and the relationship between the level of glucose, thyroid hormones and lipid profile (TC, LDL, TG, HDL) and comparison of the results with non diabetic group. The survey part of the study to determine the thyroid abnormalities, hypothyroidism or hyperthyroidism clinical or subclinical. Also the study group was divided in to two groups according to insulin requirement. Type I is insulin-dependent diabetes mellitus and type II is non insulin-dependent diabetes mellitus. The study subjects selected for this study consist of one hundred Sudanese diabetic patients, they had mean age of 46.51±10.672 years, a mean height of 162.06±10.77 cm and a mean weight of 73.47±14.91 kg. Fifty healthy non-diabetic people without endocrine disease were chosen as controls. Glucose, and thyroid hormones, thyroxine and triiodothyronine (total T 4 and T 3 ) and thyroid stimulating hormone (TSH) were measured. In addition hemoglobin (Hb), total cholesterol (TC), triglyceride (TG), high-density lipoproteins (HDL) were also measured in both groups. Low-density lipoprotein (LDL) was calculated for each sample. Physical examinations such as height, weight, and history of diabetes, family history, treatment were recorded in both groups. Determination of serum hormones concentration was carried out using highly sensitive RIA technique. While determination of blood glucose, hemoglobin, and lipid profile was carried out using enzymatic colorimetric method. The results of this study showed that: 13 patients of the population screened had thyroid disease. The commonest diagnosis was sub clinical hyperthyroidism (6%), followed by sub clinical hypothyroidism (5%) and hyperthyroidism (2%). Female patients with diabetes had the highest annual risk of developing thyroid disease but all patient

Evaluation of blood glucose and thyroid function in Sudanese diabetic patients

Energy Technology Data Exchange (ETDEWEB)

Agarib, M O.A. [Department of Biochemistry, Atomic Energy Council, Sudan Academy of Sciences, Khartoum (Sudan)

2008-03-15

This study composes of two parts. The first one is a survey of thyroid abnormalities, and the second one is experiment to estimate the level of thyroid hormones (T{sub 4}, T{sub 3}, TSH) among diabetic population and the relationship between the level of glucose, thyroid hormones and lipid profile (TC, LDL, TG, HDL) and comparison of the results with non diabetic group. The survey part of the study to determine the thyroid abnormalities, hypothyroidism or hyperthyroidism clinical or subclinical. Also the study group was divided in to two groups according to insulin requirement. Type I is insulin-dependent diabetes mellitus and type II is non insulin-dependent diabetes mellitus. The study subjects selected for this study consist of one hundred Sudanese diabetic patients, they had mean age of 46.51{+-}10.672 years, a mean height of 162.06{+-}10.77 cm and a mean weight of 73.47{+-}14.91 kg. Fifty healthy non-diabetic people without endocrine disease were chosen as controls. Glucose, and thyroid hormones, thyroxine and triiodothyronine (total T{sub 4} and T{sub 3}) and thyroid stimulating hormone (TSH) were measured. In addition hemoglobin (Hb), total cholesterol (TC), triglyceride (TG), high-density lipoproteins (HDL) were also measured in both groups. Low-density lipoprotein (LDL) was calculated for each sample. Physical examinations such as height, weight, and history of diabetes, family history, treatment were recorded in both groups. Determination of serum hormones concentration was carried out using highly sensitive RIA technique. While determination of blood glucose, hemoglobin, and lipid profile was carried out using enzymatic colorimetric method. The results of this study showed that: 13 patients of the population screened had thyroid disease. The commonest diagnosis was sub clinical hyperthyroidism (6%), followed by sub clinical hypothyroidism (5%) and hyperthyroidism (2%). Female patients with diabetes had the highest annual risk of developing thyroid

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

African Journals Online (AJOL)

Purpose: To determine the prevalence of smoking among diabetes patients ... of type 1 and 2 diabetes patients were reviewed to assess the prevalence of smoking. ... were the most prevalent race among smokers, compared with Malay and ...

Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes.

Science.gov (United States)

Papazafiropoulou, Athanasia; Sotiropoulos, Alexios; Skliros, Eystathios; Kardara, Marina; Kokolaki, Anthi; Apostolou, Ourania; Pappas, Stavros

2009-04-27

A lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D). The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patient's metabolic control and the presence of diabetic complications. A total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately. The prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05) and lower LDL-cholesterol levels (115.12 +/- 39.76 vs. 127.13 +/- 46.53 mg/dl, P = 0.006) than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.

Diabetic Retinopathy Awareness among Diabetic Patients Attending COMS-TH.

Science.gov (United States)

Dahal, P; Adhikari, H

Background Diabetic retinopathy (DR) is one of the leading causes of blindness in Nepal. Objective The main objective of the study is to know the awareness of diabetic retinopathy among new cases of diabetes mellitus (DM) attending the college of medical science- teaching hospital, Bharatpur, Nepal. Method All the diabetic cases referred for ophthalmic consultation and also referred outpatient department cases from other departments to ophthalmic outpatient department was carried out. Detailed demographics of the subjects and their awareness of potential ocular problems from diabetes mellitus were noted. Result Total one hundred and thirty-one patients were enrolled during the study period from 15 November 2016 to 15 May 2017. Brahmin 39.69% and 19.08% Mongolian were the most predominant ethnical group. The predominant group of patients were housewives (41.22%) then followed by service (19.85%), business (13.74%), agriculture (12.21%), others (12.98%). Among 36.64% of the literate patients, 19.85% had passed school level, 9.92% had passed intermediate level, 88.55% were aware of Diabetic retinopathy. Among them majority 88.55% were referred by physician. Family history were present in 35.68% and fundus evaluation was done for the first time in almost half of diabetic cases (64.12%) and diabetic retinopathy was found in 32.06% of total cases in right eye and 30.53% of total cases in left eye. Conclusion Along with the awareness, routine dilated fundoscopy is mandatory for slight threating stage of retinopathy and to reduce the burden of blindness from diabetic retinopathy in Nepal.

Evaluation of "care of the foot" as a risk factor for diabetic foot ulceration: the role of internal physicians.

Science.gov (United States)

Oguejiofor, O C; Oli, J M; Odenigbo, C U

2009-03-01

Several risk factors predispose the diabetic patient to foot ulceration, including "inadequate care of the foot". This risk factor for foot ulceration has not been previously evaluated among Nigeria diabetic patients and is the objective of this study. One hundred and twenty (120) diabetic patients with and without symptoms of peripheral neuropathy receiving care at the medical outpatient department (MOPD) and the diabetic clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi were recruited consecutively as they presented. They were administered structured questionnaires to assess some variables concerning care of their feet as provided to them by their physicians. Among the 120 diabetic participants, 83 (69.2%) had neuropathic symptoms (the symptomatic participants) while 37 (30.8%) were asymptomatic (the asymptomatic participants). Eighty (80; 96.4%) of the symptomatic vs 36 (97.3%) of the asymptomatic participants had never had their feet examined by their physician. Also, 26 (31.3%) of the symptomatic vs 12 (32.4%) of the asymptomatic participants had never received any form of advice on how to take special care of their feet by their physician, and 26 (31.3%) of the symptomatic vs 6 (16.2%) of the asymptomatic participants walked unshod most times in their immediate surroundings. Physicians do not provide adequate care to the feet of their diabetic patients irrespective of the presence or absence of neuropathic symptoms, making this variable a critical risk factor for diabetic foot ulceration and amputation. Continuing medical education to health care providers emphasizing adequate "care of the foot" of the diabetic patient, will reduce avoidable loss of limbs to diabetes.

Pharmacological effect of Ageratina pichinchensis on wound healing in diabetic rats and genotoxicity evaluation.

Science.gov (United States)

Romero-Cerecero, Ofelia; Zamilpa, Alejandro; Díaz-García, Edgar Rolando; Tortoriello, Jaime

2014-10-28

Among the main causes affecting the wound healing process, we find diabetes mellitus, which is due to the occurrence of a prolonged inflammation phase, defects in angiogenesis, and a diminution in fibroblast proliferation. The species Ageratina pichinchensis has been utilized in Mexican traditional medicine for the treatment of skin wounds. Pharmacological models have demonstrated that an extract obtained from this species improves wound healing and, through a clinical study, it was evidenced that the extract (in a pharmaceutical form) is effective in the treatment of patients with chronic venous ulcers. The 7-O-(β-D-glucopyranosyl)-galactin compound was recently identified as responsible for the pharmacological activity. The objective of the present study was to evaluate the wound healing activity of an aqueous extract and another hexane-ethyl acetate extract from Ageratina pichinchensis (both standardized in the active compound) in a diabetic foot ulcer rat model, as well as evaluating the possible genotoxic effects produced by the same species. Rats with streptozotocin-induced diabetes were submitted (under anesthesia with pentobarbital) to a circular lesion on the skin (excisional) on the rear of the paw. All animals were topically treated daily until healing. 5-methyl-1 phenyl-2-(1H) Pyridone was used as a positive control treatment. Once the wound was healed, a skin sample was obtained and utilized for histopathological analysis. The possible genotoxic effects produced by the extract, in a model of spermatozoid viability and morphology, were evaluated. The results showed that 100% of animals treated with Ageratina pichinchensis extracts presented wound healing between days 4 and 11 of treatment, while in the positive control group (treated with 5-methyl-1 phenyl-2-(1H) pyridone) and in the negative control group (vehicle), only 70% and 40%, respectively, exhibited wound healing at day 11. Histological analysis demonstrated evidences of an active regenerative

Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women.

Science.gov (United States)

Gunther, Luciene Setsuko Akimoto; Martins, Helen Priscila Rodrigues; Gimenes, Fabrícia; Abreu, André Luelsdorf Pimenta de; Consolaro, Marcia Edilaine Lopes; Svidzinski, Terezinha Inez Estivalet

2014-01-01

Vulvovaginal candidiasis (VVC) is caused by abnormal growth of yeast-like fungi on the female genital tract mucosa. Patients with diabetes mellitus (DM) are more susceptible to fungal infections, including those caused by species of Candida. The present study investigated the frequency of total isolation of vaginal Candida spp., and its different clinical profiles - colonization, VVC and recurrent VVC (RVVC) - in women with DM type 2, compared with non-diabetic women. The cure rate using fluconazole treatment was also evaluated. Cross-sectional study conducted in the public healthcare system of Maringá, Paraná, Brazil. The study involved 717 women aged 17-74 years, of whom 48 (6.7%) had DM type 2 (mean age: 53.7 years), regardless of signs and symptoms of VVC. The yeasts were isolated and identified using classical phenotypic methods. In the non-diabetic group (controls), total vaginal yeast isolation occurred in 79 (11.8%) women, and in the diabetic group in 9 (18.8%) (P = 0.000). The diabetic group showed more symptomatic (VVC + RVVC = 66.66%) than colonized (33.33%) women, and showed significantly more colonization, VVC and RVVC than seen among the controls. The mean cure rate using fluconazole was 75.0% in the diabetic group and 86.7% in the control group (P = 0.51). We found that DM type 2 in Brazilian women was associated with yeast colonization, VVC and RVVC, and similar isolation rates for C. albicans and non-albicans species. Good cure rates were obtained using fluconazole in both groups.

Protocol and baseline data from The Inala Chronic Disease Management Service evaluation study: a health services intervention study for diabetes care.

Science.gov (United States)

Askew, Deborah A; Jackson, Claire L; Ware, Robert S; Russell, Anthony

2010-05-24

Type 2 Diabetes Mellitus is one of the most disabling chronic conditions worldwide, resulting in significant human, social and economic costs and placing huge demands on health care systems. The Inala Chronic Disease Management Service aims to improve the efficiency and effectiveness of care for patients with type 2 diabetes who have been referred by their general practitioner to a specialist diabetes outpatient clinic. Care is provided by a multidisciplinary, integrated team consisting of an endocrinologist, diabetes nurse educators, General Practitioner Clinical Fellows (general practitioners who have undertaken focussed post-graduate training in complex diabetes care), and allied health personnel (a dietitian, podiatrist and psychologist). Using a geographical control, this evaluation study tests the impact of this model of diabetes care provided by the service on patient outcomes compared to usual care provided at the specialist diabetes outpatient clinic. Data collection at baseline, 6 and 12-months will compare the primary outcome (glycaemic control) and secondary outcomes (serum lipid profile, blood pressure, physical activity, smoking status, quality of life, diabetes self-efficacy and cost-effectiveness). This model of diabetes care combines the patient focus and holistic care valued by the primary care sector with the specialised knowledge and skills of hospital diabetes care. Our study will provide empirical evidence about the clinical effectiveness of this model of care. Australian New Zealand Clinical Trials Registry ACTRN12608000010392.

CERN diabetes awareness days

CERN Multimedia

2004-01-01

Do you have diabetes without knowing it? The Medical Service invites everyone working at CERN to participate in the above PREVENTION and DETECTION campaign on the: 8 and 9 November 2004 from 9:00 to 16:00 at the infirmary, bldg. 57, ground floor Personal evaluation of diabetes risks, (blood pressure, cholesterol and sugar levels, Body Mass Index measurements and more...) will be offered as well as leaflets, information and advice, (diet, exercise). A dietician specialised in diabetes will be on hand from 14:00 until 16:00. Diabetes is reaching epidemic proportions in many countries due to an increase in obesity, sedentary lifestyles and poor diet. Diabetes is a major cause of blindness, cardio-vascular and kidney disease. An estimated 30-50% of these cases of diabetes go undetected, despite de fact that easy and efficient prevention exists. Diabetes discovered and treated early is not a severe condition but untreated and ignored it can have dire consequences.

CERN diabetes awareness days

CERN Multimedia

2004-01-01

Do you have diabetes without knowing it? The Medical Service invites everyone working at CERN to participate in the above PREVENTION and DETECTION campaign on the: 8 and 9 November 2004 from 9 am to 4 pm at the infirmary, bldg. 57, ground floor Personal evaluation of diabetes risks, (blood pressure, cholesterol and sugar levels, Body Mass Index measurements and more...) will be offered as well as leaflets, information and advice, (diet, exercise). A dietician specialised in diabetes will be on hand from 2 pm until 4 pm. Diabetes is reaching epidemic proportions in many countries due to an increase in obesity, sedentary lifestyles and poor diet. Diabetes is a major cause of blindness, cardio-vascular and kidney disease. An estimated 30-50% of these cases of diabetes go undetected, despite de fact that easy and efficient prevention exists. Diabetes discovered and treated early is not a severe condition but untreated and ignored it can have dire consequences.

Mediterranean Diet and Diabetes: Prevention and Treatment

Science.gov (United States)

Georgoulis, Michael; Kontogianni, Meropi D.; Yiannakouris, Nikos

2014-01-01

The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventional studies assessing the effect of the Mediterranean diet on diabetes control and the management of diabetes-related complications. The above mentioned data are explored on the basis of evaluating the Mediterranean diet as a whole dietary pattern, rather than focusing on the effect of its individual components. Possible protective mechanisms of the Mediterranean diet against diabetes are also briefly discussed. PMID:24714352

Anti-Diabetic, Anti-Oxidant and Anti-Hyperlipidemic Activities of Flavonoids from Corn Silk on STZ-Induced Diabetic Mice.

Science.gov (United States)

Zhang, Yan; Wu, Liying; Ma, Zhongsu; Cheng, Jia; Liu, Jingbo

2015-12-23

Corn silk is a well-known ingredient frequently used in traditional Chinese herbal medicines. This study was designed to evaluate the anti-diabetic, anti-oxidant and anti-hyperlipidemic activities of crude flavonoids extracted from corn silk (CSFs) on streptozotocin (STZ)-induced diabetic mice. The results revealed that treatment with 300 mg/kg or 500 mg/kg of CSFs significantly reduced the body weight loss, water consumption, and especially the blood glucose (BG) concentration of diabetic mice, which indicated their potential anti-diabetic activities. Serum total superoxide dismutase (SOD) and malondialdehyde (MDA) assays were also performed to evaluate the anti-oxidant effects. Besides, several serum lipid values including total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C) were reduced and the high density lipoprotein cholesterol level (HDL-C) was increased. The anti-diabetic, anti-oxidant and anti-hyperlipidemic effect of the CSFs suggest a potential therapeutic treatment for diabetic conditions.

New-onset diabetes and antihypertensive treatment

Directory of Open Access Journals (Sweden)

Rychlik, Reinhard

2010-03-01

Full Text Available Introduction: Chronic diseases substantially contribute to the continuous increase in health care expenditures, including type-2 diabetes mellitus as one of the most expensive chronic diseases. Arterial hypertension presents a risk factor for the development of type-2 diabetes mellitus. Numerous analyses have demonstrated that antihypertensive therapies promote the development of type-2-diabetes mellitus. Studies indicate, that the application of angiotensin converting enzyme (ACE inhibitors and angiotensin-receptor-blockers (ARB lead to less new-onset diabetes compared to beta-blockers, diuretics and placebo. Given that beta-blockers and diuretics impair the glucose metabolism, the metabolic effects of different antihypertensive drugs should be regarded; otherwise not only the disease itself, but also antihypertensive therapies may promote the development of new-onset diabetes. Even though, the cost of ACE inhibitors and ARB are higher, the use in patients with metabolic disorders could be cost-effective in the long-term if new-onset diabetes is avoided. Objectives: To evaluate which class of antihypertensive agents promote the development or the manifestation of type-2 diabetes mellitus. How high is the incidence of new-onset diabetes during antihypertensive therapy and how is treatment-induced type-2 diabetes mellitus evaluated clinically? Which agents are therefore cost-effective in the long term? Which ethical, social or legal aspects should be regarded?MethodsA systematic literature review was conducted including clinical trials with at least ten participants which reported new-onset diabetes in the course of antihypertensive treatment. The trials had to be published after 1966 (after 2003 for economic publications in English or German. Results: A total of 34 clinical publications meet the inclusion criteria. Of these, eight publications focus on the development of diabetes mellitus under treatment with diuretic and/or beta-blockers, six

A Diabetes Mobile App With In-App Coaching From a Certified Diabetes Educator Reduces A1C for Individuals With Type 2 Diabetes.

Science.gov (United States)

Kumar, Shefali; Moseson, Heidi; Uppal, Jaspreet; Juusola, Jessie L

2018-06-01

Purpose There are currently many diabetes apps available, but there is limited evidence demonstrating clinical impact. The purpose of this study is to evaluate the impact of a diabetes mobile app with in-app coaching by a certified diabetes educator on glycemic control for individuals with type 2 diabetes. Methods A 12 week-long single-arm intent-to-treat trial evaluated the impact of a diabetes mobile app and coaching program (One Drop | Mobile With One Drop | Experts), which facilitated tracking of self-care and included an in-app diabetes education program, on A1C for individuals with type 2 diabetes and an A1C ≥7.5% (58 mmol/mol). An online study platform (Achievement Studies, Evidation Health Inc, San Mateo, CA) was used to screen, consent, and enroll participants; collect study data; and track participants' progress throughout the study. Baseline and study end A1C measurements as well as questionnaire data from participants were collected. Results Participants (n = 146) were 52 ± 9 years old, 71% female, 25% black or Hispanic, diagnosed with diabetes for 11 ± 7 years, and with a mean baseline A1C of 9.87% ± 2.0 (84 mmol/mol). In adjusted repeated measures models, mean A1C improved by -0.86% among study completers (n = 127), -0.96% among active users of the app and coaching program (n = 93), and -1.32% among active users with a baseline A1C ≥9.0% (75 mmol/mol) (n = 53). Conclusions This program was associated with a clinically meaningful and significant reduction in A1C and can potentially increase access to effective diabetes self-management education and support for individuals with diabetes.

Presentation of frozen shoulder among diabetic and non-diabetic patients☆

Science.gov (United States)

Uddin, Mohammad Moin; Khan, Aminuddin A.; Haig, Andrew J.; Uddin, Mohammad Kafil

2014-01-01

Objective The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. Design This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Results Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). Conclusions No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes. PMID:25983497

Presentation of frozen shoulder among diabetic and non-diabetic patients.

Science.gov (United States)

Uddin, Mohammad Moin; Khan, Aminuddin A; Haig, Andrew J; Uddin, Mohammad Kafil

2014-12-01

The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes.

Imaging in syndrome complex diabetes mellitus. Current standards and future perspectives; Bildgebung im Syndromkomplex Diabetes mellitus. Stellenwert und Chancen

Energy Technology Data Exchange (ETDEWEB)

Hetterich, H.; Schafnitzel, A. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Bamberg, F. [Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany)

2015-04-01

Diabetes mellitus is a highly prevalent multisystemic disorder with numerous potential complications and substantial socioeconomic consequences. In many cases, the patient history, physical examination and laboratory tests are not sufficient for a comprehensive evaluation of complicating disorders. Imaging modalities, such as sonography, computed tomography (CT) and magnetic resonance imaging (MRI) are of major significance in the evaluation of complicating disorders of diabetes according to current guidelines. Examples include assessment of coronary artery disease, peripheral artery disease, stroke and diabetic foot syndrome. Technical developments allow a substantial reduction in radiation dose and scan time in CT and MRI, respectively and could therefore justify a broader application in this patient population. In the future CT and MRI could also be used for the early detection of diabetic complications. Furthermore, they could also be used for risk stratification, e.g. measurement of hepatic fat content and evaluation of atherosclerosis in whole body MRI. Prior to widespread application of advanced imaging techniques in this patient population, improved outcomes with respect to survival, quality of life and cost-effectiveness need to be demonstrated. Diagnostic imaging modalities for the evaluation of the syndrome complex of diabetic disorders should be used according to the current guidelines but the use is predicted to increase given the high potential in this population. (orig.) [German] Diabetes mellitus ist eine hochpraevalente Multisystemerkrankung mit zahlreichen Komplikationen und bedeutenden soziooekonomischen Konsequenzen. Die Folgeerkrankungen koennen oft nicht abschliessend mittels Anamnese, koerperlicher Untersuchung und laborchemischen Verfahren evaluiert werden. Radiologische Verfahren wie die Sonographie, Computertomographie (CT) und Magnetresonanztomographie (MRT) haben gemaess verschiedener Leitlinien einen festen Stellenwert bei der

Comparing the oral health status of diabetic and non-diabetic children from Puerto Rico: a case-control pilot study.

Science.gov (United States)

López del Valle, Lydia M; Ocasio-López, Carlos

2011-09-01

Children with type 1 diabetes have infrequently been the subjects of studies examining oral health status (caries and gingival diseases); in addition, no study of this type has ever been on Puerto Rican children. The purpose of this study was to evaluate the oral health status of Puerto Rican children (ranging in age from 6 to 12 years) either with or without type 1 diabetes and compare the two groups with regard to that status. This was a matched case-control study. A convenience sample of 25 children with type 1 diabetes (cases) and 25 non-diabetic children (controls), all ranging in age from 6 to 12 years and matched by age and gender, was evaluated by a calibrated dentist for caries, bleeding on probing, and plaque and calculus indexes. A sample of saliva was taken from each subject and analyzed to determine Streptococcus mutans and Lactobacillus counts. Descriptive statistics, chi-square test, and t-test were used to describe and assess the data. We used the caries index to evaluate the teeth of the children participating in our study; we found significant differences in the number of lesions in the permanent teeth of diabetic children compared to the number found in the permanent teeth of non-diabetic children (1.43 and 0.56, respectively; p = 0.05). The mean number of sites of bleeding on probing for diabetic children was 23.9; for non-diabetic children it was 4.2. Diabetic children had more plaque than did the control children (plaque index = 2.5 vs. 0.8; p = 0.007) and more bleeding on probing (p = 0.001). High levels of glycosylated hemoglobin in diabetic children were statistically significantly associated with a greater number of sites with bleeding on probing. Diabetic children are at higher risk for caries and gum disease than are non-diabetic children.

The Kynurenine Pathway: a Proposed Mechanism Linking Diabetes and Periodontal Disease in Diabetic Patients

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Rishabh Kapila

2011-07-01

Full Text Available Introduction: Diabetes mellitus is a metabolic disease characte-rized by dysregulation of carbohydrate, protein and lipid metabolism. Diabetes could result, in part, in activation of tryptophan metabolism. Diabetic patients are more susceptible to gingivitis and periodontitis than healthy subjects. The salivary kynurenine derivatives are also implicated in the onset and development of periodontal dis-ease in humans.The hypothesis: We propose that the tryptophan metabolites via kynurenine pathway may lead to diabetes and an increased severity of periodontal disease in diabetic patients, thus linking both diabetes and periodontal disease.Evaluation of the hypothesis: Tryptophan has been found in significant amount in saliva in diabetic individuals in some studies, particularly tryptophan metabolites like kynurenine and anthranilic acid. Moreover, altered tryptophan metabolism has also been reported in the onset of periodontal disease. Thus, this correlation between diabetes mellitus, periodontal disease and salivary tryptophan metabolite levels could be related to the impaired kynurenine pathway metabolism of tryptophan.

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

[Evaluation of diabetic retinopathy screening using non-mydriatic fundus camera performed by physicians' assistants in the endocrinology service].

Science.gov (United States)

Barcatali, M-G; Denion, E; Miocque, S; Reznik, Y; Joubert, M; Morera, J; Rod, A; Mouriaux, F

2015-04-01

Since 2010, the High Authority for health (HAS) recommends the use of non-mydriatic fundus camera for diabetic retinopathy screening. The purpose of this study is to evaluate the results of screening for diabetic retinopathy using the non-mydriatic retinal camera by a physician's assistant in the endocrinology service. This is a retrospective study of all diabetic patients hospitalized in the endocrinology department between May 2013 and November 2013. For each endocrinology patient requiring screening, a previously trained physician's assistant performed fundus photos. The ophthalmologist then provided a written interpretation of the photos on a consultant's sheet. Of the 120 patients screened, 40 (33.3%) patients had uninterpretable photos. Among the 80 interpretable photos, 64 (53.4%) patients had no diabetic retinopathy, and 16 (13.3%) had diabetic retinopathy. No patient had diabetic maculopathy. Specific quality criteria were established by the HAS for screening for diabetic retinopathy using the non-mydriatic retinal camera in order to ensure sufficient sensitivity and specificity. In our study, the two quality criteria were not achieved: the rates of uninterpretable photos and the total number of photos analyzed in a given period. In our center, we discontinued this method of diabetic retinopathy screening due to the high rate of uninterpretable photos. Due to the logistic impossibility of the ophthalmologists taking all the fundus photos, we proposed that the ophthalmic nurses take the photos. They are better trained in the use of the equipment, and can confer directly with an ophthalmologist in questionable cases and to obtain pupil dilation as necessary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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

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

International Nuclear Information System (INIS)

Huang Qilin; An Yarui; Tang Linlin; Jiang Xiaoli; Chen Hua; Bi Wenji; Wang Zhongchuan; Zhang Wen

2011-01-01

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 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 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: ► A novel biosensor was developed to determine glucose and cholesterol simultaneously. ► The dual enzymatic-biosensor has good selectivity and high sensitivity. ► We determined glucose and cholesterol in the real samples of diabetic mice. ► The results showed that high glucose might increase the macrophage cholesterol level. ► It provided useful experimental evidences for diabetes-accelerate atherosclerosis. - Abstract: In this paper, a novel dual enzymatic-biosensor is described for

Audit diabetes-dependent quality of life questionnaire: usefulness in diabetes self-management education in the Slovak population.

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Holmanová, Elena; Ziaková, Katarína

2009-05-01

This paper reports a study to test validity and internal consistency of the audit diabetes-dependent quality of life questionnaire in the Slovak population and to evaluate its usefulness in the context of education of people with diabetes. The individualised instruments designed to measure individuals' perceptions of the impact of diabetes on their quality of life may be helpful to identify individuals' preferences, motivational deficits in diabetes management and to tailor individual treatment strategies. Survey. After linguistic validation, the structure of the questionnaire was tested using factor analysis on 104 patients who were recruited from the National Institute of Endocrinology and Diabetology in Lubochna. Internal consistency was evaluated by computing Cronbach's alpha. Clinical variables related to the quality of life were analysed using one-way ANOVA, multifactor ANOVA, Pearson's and Spearman's rank correlation coefficients. A one-dimensional scale structure was supported and internal consistency was high (alpha = 0.93). Variance in impact of diabetes on quality of life was explained by age, presence of late complications and type of insulin regimen. The audit diabetes-dependent quality of life is culturally appropriate, valid and reliable in the sample of Slovak patients attending the educational programme. Our results agreed with previous European and Asian studies supporting its usefulness in the context of diabetes self-management education. Individualised diabetes-specific quality of life measures allow better understanding of patients' treatment preferences and, consequently, more effective prioritizing and targeting of appropriate educational interventions. This instrument may be useful in routine clinical practice and as an outcome measure for international clinical research trials evaluating effectiveness of educational programmes.

Evaluación crítica del sistema de diagnóstico de la diabetes mellitus, propuesto por la Asociación Americana de Diabetes Critical evaluation of the diagnostic system of diabetes mellitus proposed by the American Diabetes Association

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Roberto M. González Suárez

2002-08-01

Full Text Available Se realizó un estudio retrospectivo en 370 sujetos con trastornos de tolerancia a la glucosa, para evaluar la metodología de diagnóstico de la diabetes mellitus tipo 2, que prescinde de la prueba de tolerancia a la glucosa oral (PTG, propuesto por la ADA. Se encontró que la glucemia en ayunas permitió diagnosticar el 27 % de los diabéticos y el 56 % de los sujetos con trastornos de la regulación de la glucemia, que se hubieran diagnosticado siguiendo los criterios de la OMS que incluyen la PTG; la tercera parte de los casos clasificados como normales según la glucemia en ayunas solamente, presentó algún tipo de trastorno de la tolerancia a la glucosa. Se comprobó que los diabéticos detectados mediante la hiperglucemia a la segunda hora de la PTG, presentan niveles superiores de glucosa circulante durante la prueba, evaluados por el área total bajo la curva de glucosa. El patrón de respuesta insulínica de estos casos se caracterizó por una respuesta inicial disminuida que se incrementó hasta alcanzar valores máximos a la segunda hora; la frecuencia de casos con baja respuesta insulínica y/o resistencia a la insulina fue alta. Se concluyó que la glucemia en ayunas, como única prueba, no tiene sensibilidad suficiente para detectar trastornos de la tolerancia a la glucosa y diabetes mellitus y los casos con hiperglucemia posprandial únicamente, y que por ello solo pueden ser detectados por la PTG, presentan trastornos metabólicos importantes que requieren su detección y tratamiento precoz por lo cual es recomendable el uso sistemático de la PTG en el diagnóstico de la diabetes mellitus.A retrospective study was carried out in 370 subjects with glucose tolerance disorders aimed at evaluating the methodology for diagnosing type 2 diabetes mellitus that leaves out the oral glucose tolerance test (GTT proposed by the ADA, It was found that fasting glycaemia allowed to diagnose 27 % of the diabetics and 56 % of the individuals

Indonesia Cohort of IO HAT Study to Evaluate Diabetes Management, Control, and Complications in Retrospective and Prospective Periods Among Insulin-Treated Patients with Type 1 and Type 2 Diabetes

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Achmad Rudijanto

2018-04-01

Full Text Available Background: hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM or type 2 diabetes mellitus (T2DM in the Indonesian cohort. Methods: this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357. The patients of ≥18 years of age and treated with insulin for >12 months were selected for this study (ClinicalTrials.gov number: NCT02306681. Results: a total of 374 patients were enrolled in this study and completed SAQ1. All patients with T1DM (17 [100%], and 347 (97.2% patients with T2DM completed SAQ2. Almost all the patients in the 4-week prospective period reported at least one hypoglycemic event (T1DM 100%, T2DM 99.4% and the incidence rate of any hypoglycemia was 67.5 events per patient-year (PPY and 25.7 events PPY for T1DM and T2DM patients, respectively. Among patients with T1DM and T2DM, 5.9% and 36.4%, respectively, did not know what hypoglycemia was at baseline, also high proportion of patients had impaired hypoglycemic awareness in the study (82.4% and 62.7%, respectively. Conclusion: overall, high proportion of patients reported hypoglycemic events in the prospective period indicating under reporting during the retrospective period due to recall bias. Therefore, there is a need for patient education program to improve the awareness of hypoglycemia in diabetes patient in Indonesia.

PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

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A. Bostak

2006-11-01

Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

The Role of Salivary Gland Scintigraphy in the Evaluation of Salivary Gland Dysfunction in Uncontrolled Type II Diabetic Patients

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Senthilkumar, B.; Sathasivasubramanian, S.

2013-01-01

The aim of the present study was to evaluate the salivary gland dysfunction in patients with uncontrolled type II diabetes using salivary gland scintigraphy and then to compare these ratios with quantitative whole salivary secretion rates. Using a gamma camera (siemens-diacam) equipped with a low energy all-purpose collimator, 32 uncontrolled type II diabetic patients and 30 normal healthy patients were studied by injecting a radio isotope (technetium 99m pertechnetate) about 5 mCi was inject...

MANAGEMENT OF DIABETES MELLITUS IN DIABETIC PATIENTS: ISFAHAN. 1999

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P ABAZARI

2001-06-01

Full Text Available Introduction. Diabetic control and its acute and chronic complications needed to investigate the characteristics medical and self care in diabetics. This evaluation can detect conflicts in this field and provide the possibility of better planning to arrive the ideal control of diabetes. Methods. This study was a cross sectional survey. Samples were 344 diabetic patients who were living in Isfahan. Data was collected by a questionnaire described diabetics contextual characteristics, position of medical services use, position of diabetic education, self blood glucose monitoring (SMBG, attendance to diet regimen and so on. Questionnaires were cmpeleted through interview. Results. Mean age of patients was 56.5±13.6 years. More than fifty percent (57.7 percent were female. More than one third (57.6 percent were illiterate. Patients had 1 to 40 years history of diabetes. More than one forth (27.4 percent did not seek medical advice and 61.2 percent had referred to physician only when they were encountering with a problem for example lack of insulin or oral hypoglycemic agents. Over eighty percent never had foot examination by their physicians. Only 7.4 percent, had heared about glycosylated hemoglubine. This test had not been accomplished for 95.9 percent of patients. 46.2 percent had not performed self foot examination till study time. More than eighty percent of interviewers had reported their lost blood glucose value above 130 mg/dl. Only ten percent of the study population had performed 5MBG. About fifty percent (45.3 percent, did not educated about diabetes. Only 26.8 percent reported that they always follow their dietary regimen. Discussion. Results of this survey showed irregular calls to physicians, poor blood glucose control, high rate of hospitalization due to acute and chronic diabetes complications, irregular blood glucose monitoring. Diabetes management needs more attention in our city.

Evaluation of the glycemic effect of Ceratonia siliqua pods (Carob on a streptozotocin-nicotinamide induced diabetic rat model

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Mousa A. Qasem

2018-05-01

Full Text Available Background Ceratonia siliqua pods (carob have been nominated to control the high blood glucose of diabetics. In Yemen, however, its antihyperglycemic activity has not been yet assessed. Thus, this study evaluated the in vitro inhibitory effect of the methanolic extract of carob pods against α-amylase and α-glucosidase and the in vivo glycemic effect of such extract in streptozotocin-nicotinamide induced diabetic rats. Methods 2,2-diphenyl-1-picrylhydrazyl (DPPH and Ferric reducing antioxidant power assay (FRAP were applied to evaluate the antioxidant activity of carob. In vitro cytotoxicity of carob was conducted on human hepatocytes (WRL68 and rat pancreatic β-cells (RIN-5F. Acute oral toxicity of carob was conducted on a total of 18 male and 18 female Sprague-Dawley (SD rats, which were subdivided into three groups (n = 6, namely: high and low dose carob-treated (CS5000 and CS2000, respectively as well as the normal control (NC receiving a single oral dose of 5,000 mg kg−1 carob, 2,000 mg kg−1 carob and 5 mL kg−1 distilled water for 14 days, respectively. Alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, total bilirubin, creatinine and urea were assessed. Livers and kidneys were harvested for histopathology. In vitro inhibitory effect against α-amylase and α-glucosidase was evaluated. In vivo glycemic activity was conducted on 24 male SD rats which were previously intraperitoneally injected with 55 mg kg−1 streptozotocin (STZ followed by 210 mg kg−1nicotinamide to induce type 2 diabetes mellitus. An extra non-injected group (n = 6 was added as a normal control (NC. The injected-rats were divided into four groups (n = 6, namely: diabetic control (D0, 5 mg kg−1glibenclamide-treated diabetic (GD, 500 mg kg−1 carob-treated diabetic (CS500 and 1,000 mg kg−1 carob-treated diabetic (CS1000. All groups received a single oral daily dose of their treatment for 4 weeks. Body weight, fasting blood

Biologic Evaluation of Diabetes and Local Recurrence in Non-Small Cell Lung Cancer.

Science.gov (United States)

Yang, Xuebin; Liu, Yongjun; Mani, Haresh; Olson, Jeffrey; Clawson, Gary; Caruso, Carla; Bruggeman, Richard; Varlotto, John M; Zander, Dani S; Rassaei, Negar

2017-01-01

A recent multicenter study led by our institution demonstrated that local recurrence of non-small cell lung cancer (NSCLC) was significantly more frequent in patients with diabetes, raising the possibility of different tumor biology in diabetics. Epithelial-to-mesenchymal transition (EMT) plays a key role in local tumor recurrence and metastasis. In the present study, we investigated differences of tumor microenvironment between patients with and without diabetes by examining expression of EMT markers. Seventy-nine NSCLC patients were selected from the cohort of our early multicenter study. These patients were classified into 4 groups: 39 with adenocarcinoma with (n = 19) and without (n = 20) diabetes, and 40 with squamous cell carcinoma with (n = 20) and without (n = 20) diabetes. Immunohistochemical expression of eight EMT markers was analyzed, including transforming growth factor-beta (TGF-β), epidermal growth factor receptor (EGFR), insulin-like growth factor 1 receptor (IGF-1R), vimentin, E-cadherin, N-cadherin, HtrA1, and beta-catenin. Five markers (E-cadherin, HtrA1, TGF-β, IGF-1R and vimentin) demonstrated significantly higher expression in diabetics than in non-diabetics in both histology types. N-cadherin had higher expression in diabetics, though the difference did not reach statistical significance. EGFR showed a higher expression in diabetics in squamous cell carcinoma only. Beta-catenin was the only marker with no difference in expression between diabetics versus non-diabetics. Our findings suggest that diabetes is associated with enhanced EMT in NSCLC, which may contribute to growth and invasiveness of NSCLC.

Emotional dysfunction associated with diabetes in Mexican adolescents and young adults with type-1 diabetes

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Lerman-Garber Israel

2003-01-01

Full Text Available OBJECTIVE: To assess the emotional dysfunction associated with diabetes in Mexican young individuals with type-1 diabetes. MATERIAL AND METHODS: A cross-sectional survey was conducted to perform a complete clinical and psychosocial evaluation of 93 consecutive type-1 diabetes patients, aged 14 to 30 years. RESULTS: Adolescents had higher scores of emotional dysfunction related to diabetes and a diminished knowledge in diabetes-related areas. A multivariate logistic regression model showed that an inadequate emotional response to diabetes (high problem areas in diabetes or PAID scores was mainly associated with a poor glycemic control (OR=2.9, 95% CI 0.9-9.7, p=0.09. Apprehension about the future and the possibility of serious complications had the highest mean PAID score in all age groups. CONCLUSIONS: New strategies should be developed to improve the routine care and support of young individuals with type-1 diabetes.

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 ...

Anti-Diabetic, Anti-Oxidant and Anti-Hyperlipidemic Activities of Flavonoids from Corn Silk on STZ-Induced Diabetic Mice

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Yan Zhang

2015-12-01

Full Text Available Corn silk is a well-known ingredient frequently used in traditional Chinese herbal medicines. This study was designed to evaluate the anti-diabetic, anti-oxidant and anti-hyperlipidemic activities of crude flavonoids extracted from corn silk (CSFs on streptozotocin (STZ-induced diabetic mice. The results revealed that treatment with 300 mg/kg or 500 mg/kg of CSFs significantly reduced the body weight loss, water consumption, and especially the blood glucose (BG concentration of diabetic mice, which indicated their potential anti-diabetic activities. Serum total superoxide dismutase (SOD and malondialdehyde (MDA assays were also performed to evaluate the anti-oxidant effects. Besides, several serum lipid values including total cholesterol (TC, triacylglycerol (TG, low density lipoprotein cholesterol (LDL-C were reduced and the high density lipoprotein cholesterol level (HDL-C was increased. The anti-diabetic, anti-oxidant and anti-hyperlipidemic effect of the CSFs suggest a potential therapeutic treatment for diabetic conditions.

Candida colonization on the denture of diabetic and non-diabetic patients

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Mohammad Hossein Lotfi-Kamran

2009-01-01

Full Text Available Background: Oral candidiasis is a common opportunistic infection in diabetic patients. Presence of denture in the oral cavity of diabetic patients can promote Candida colonization and results in the higher incidence of oral and systemic candidiasis. The general purpose of the present study was to evaluate and compare Candida colonization in denture of diabetic patients and non-diabetic control group. Methods: In current case-control study, samples for mycological examinations were collected from the palatal impression surface of maxillary dentures from 92 edentulous patients including 46 dia-betic and 46 non-diabetic denture wearers. All samples were cultured directly on sabouraud agar me-dium and isolated colonies were counted and identified based on specific tests. Data were statistically analyzed using Mann-Whitney and Spearman correlation tests. Results: The higher density of isolated colonies was seen in diabetic group in compare with control group (P = 0.0001. There was a statistically significant correlation between the blood glucose level (P = 0.0001 and the duration of denture usage (P = 0.022 with the colonization of Candida on den-ture of diabetic patients. C. albicans was the most common isolated Candida species in both groups, though diabetic patients with dentures had more non-albicans Candida isolated from their dentures compared to non-diabetic patients. Conclusions: Mycological findings from the present study revealed that diabetes mellitus can in-crease colonization of Candida in denture and mouth. By elimination of local and systemic factors in diabetic patients and improving their oral health care, Candida colonization and the risk of oral and systemic candidiasis will be decreased.

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....

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...

Diabetes mellitus defined by hemoglobin A1c value: Risk characterization for incidence among Japanese subjects in the JPHC Diabetes Study.

Science.gov (United States)

Kato, Masayuki; Takahashi, Yoshihiko; Matsushita, Yumi; Mizoue, Tetsuya; Inoue, Manami; Kadowaki, Takashi; Tsugane, Shoichiro; Noda, Mitsuhiko

2011-10-07

Aims/Introduction:  Although several risk factors for type 2 diabetes have been identified, most of them have been identified in studies on Western populations, and they should be evaluated in a Japanese population. In 2010, new diagnostic criteria for diabetes mellitus using hemoglobin A1c (HbA1c) were released and its use in epidemiological studies has many advantages. The aim of the present study was to evaluate risk factors for type 2 diabetes defined based on HbA1c values in a Japanese population.   A total of 9223 subjects (3076 men and 6147 women) were followed up for 5 years. Diabetes was defined based on self-report or HbA1c value. Risk factors for diabetes were evaluated as odds ratios adjusted for potential confounding factors by logistic regression.   During the 5-year follow-up period, we documented 518 incident cases of diabetes (232 men and 286 women). Of the 518 incident cases, 310 cases were diagnosed by HbA1c alone. Among the men, age, smoking (both past smoking and current smoking) and family history of diabetes significantly increased the risk of diabetes. Among the women, body mass index, family history of diabetes and hypertension significantly increased the risk of diabetes. These results did not change markedly after adjustment for the baseline HbA1c values, and the baseline HbA1c value itself was a significant risk factor for diabetes mellitus.   Known risk factors for diabetes established in Western populations also increased the risk of diabetes in a Japanese population defined on the basis of HbA1c values. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00119.x, 2011).

Impact of diabetic serum on endothelial cells: An in-vitro-analysis of endothelial dysfunction in diabetes mellitus type 2

International Nuclear Information System (INIS)

Muenzel, Daniela; Lehle, Karla; Haubner, Frank; Schmid, Christof; Birnbaum, Dietrich E.; Preuner, Juergen G.

2007-01-01

Diabetic endothelial dysfunction was characterized by altered levels of adhesion molecules and cytokines. Aim of our study was to evaluate the effects of diabetic serum on cell-growth and proinflammatory markers in human saphenous vein endothelial cells (HSVEC) from diabetic and non-diabetic patients. Diabetic serum showed (1) complementary proliferative activity for non-diabetic and diabetic HSVEC, (2) unchanged surface expression of adhesion molecules, and (3) elevated levels of sICAM-1 in HSVEC of all donors. The concentration of sVCAM-1 was increased only in diabetic cells. The proinflammatory state of diabetic HSVEC characterized by increased levels of cytokines was compensated. We concluded that even under normoglycemic conditions the serum itself contains critical factors leading to abnormal regulation of inflammation in diabetics. We introduced an in vitro model of diabetes representing the endothelial situation at the beginning of diabetes (non-diabetic cells/diabetic serum) as well as the diabetic chronic state (diabetic cells/diabetic serum)

Evaluation of the quality of care of a multi-disciplinary risk factor assessment and management programme (RAMP for diabetic patients

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Fung Colman SC

2012-12-01

Full Text Available Abstract Background Type 2 Diabetes Mellitus (DM is a common chronic disease associated with multiple clinical complications. Management guidelines have been established which recommend a risk-stratified approach to managing these patients in primary care. This study aims to evaluate the quality of care (QOC and effectiveness of a multi-disciplinary risk assessment and management programme (RAMP for type 2 diabetic patients attending government-funded primary care clinics in Hong Kong. The evaluation will be conducted using a structured and comprehensive evidence-based evaluation framework. Method/design For evaluation of the quality of care, a longitudinal study will be conducted using the Action Learning and Audit Spiral methodologies to measure whether the pre-set target standards for criteria related to the structure and process of care are achieved. Each participating clinic will be invited to complete a Structure of Care Questionnaire evaluating pre-defined indicators which reflect the setting in which care is delivered, while process of care will be evaluated against the pre-defined indicators in the evaluation framework. Effectiveness of the programme will be evaluated in terms of clinical outcomes, service utilization outcomes, and patient-reported outcomes. A cohort study will be conducted on all eligible diabetic patients who have enrolled into RAMP for more than one year to compare their clinical and public service utilization outcomes of RAMP participants and non-participants. Clinical outcome measures will include HbA1c, blood pressure (both systolic and diastolic, lipids (low-density lipoprotein cholesterol and future cardiovascular diseases risk prediction; and public health service utilization rate will include general and specialist outpatient, emergency department attendances, and hospital admissions annually within 5 years. For patient-reported outcomes, a total of 550 participants and another 550 non-participants will be

Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women

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Luciene Setsuko Akimoto Gunther

Full Text Available CONTEXT AND OBJECTIVE: Vulvovaginal candidiasis (VVC is caused by abnormal growth of yeast-like fungi on the female genital tract mucosa. Patients with diabetes mellitus (DM are more susceptible to fungal infections, including those caused by species of Candida. The present study investigated the frequency of total isolation of vaginal Candida spp., and its different clinical profiles - colonization, VVC and recurrent VVC (RVVC - in women with DM type 2, compared with non-diabetic women. The cure rate using fluconazole treatment was also evaluated. DESIGN AND SETTING: Cross-sectional study conducted in the public healthcare system of Maringá, Paraná, Brazil. METHODS: The study involved 717 women aged 17-74 years, of whom 48 (6.7% had DM type 2 (mean age: 53.7 years, regardless of signs and symptoms of VVC. The yeasts were isolated and identified using classical phenotypic methods. RESULTS: In the non-diabetic group (controls, total vaginal yeast isolation occurred in 79 (11.8% women, and in the diabetic group in 9 (18.8% (P = 0.000. The diabetic group showed more symptomatic (VVC + RVVC = 66.66% than colonized (33.33% women, and showed significantly more colonization, VVC and RVVC than seen among the controls. The mean cure rate using fluconazole was 75.0% in the diabetic group and 86.7% in the control group (P = 0.51. CONCLUSION: We found that DM type 2 in Brazilian women was associated with yeast colonization, VVC and RVVC, and similar isolation rates for C. albicans and non-albicans species. Good cure rates were obtained using fluconazole in both groups.

The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

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Giuseppe Scarpa

2016-01-01

Full Text Available Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority. Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy, were invited to be enrolled in the screening programme. The “no prevention strategy” with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach. Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34% were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (−13.71%. Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes.

Liver Stiffness Evaluation by Transient Elastography in Type 2 Diabetes Mellitus Patients with Ultrasound-proven Steatosis.

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Sporea, Ioan; Mare, Ruxandra; Lupușoru, Raluca; Sima, Alexandra; Sirli, Roxana; Popescu, Alina; Timar, Romulus

2016-06-01

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The aim of our study was to evaluate a population of diabetic patients regarding the severity of liver steatosis and liver fibrosis. The study included 392 type 2 diabetic patients prospectively randomized, evaluated in the same session by transabdominal ultrasound to assess steatosis and by liver elastography to assess fibrosis (Transient Elastography - TE, FibroScan, EchoSens). Steatosis severity was graded using a semi-quantitative scale (S0-no steatosis; S1-mild steatosis; S2-moderate steatosis; S3-severe steatosis). For differentiation between stages of liver fibrosis, the following cut-off values were used (Wong et al., 2010): F2-F3: 7-10.2kPa, F4>/=10.3 kPa. Reliable elastographic measurements were obtained in 76% (298/392) patients. By using the proposed cut-off values, significant fibrosis (F2-F3) was found in 18.8% (56) patients with steatosis, while 13.8% (41) had cirrhosis (F4). Significant fibrosis (F2-F3) was found in 20.4% (20/98) of the patients with S1, in 18.6% (22/118) of those with S2 and in 31.8% (14/44) of those with S3, while cirrhosis (F4) was diagnosed in 7.1% (7/98) patients with S1, in 20.3% (24/118) of those with S2 and in 22.7% (10/44) of those with S3. Liver steatosis diagnosed by ultrasound is very frequently found in type 2 diabetes mellitus patients, more than half of them having moderate/severe steatosis. A significant liver stiffness increase was found in more than 30% of these patients. Liver stiffness assessment in type 2 diabetic patients should be performed systematically to identify those with significant liver fibrosis.

Increased left ventricular mass in normotensive type 1 diabetic patients with diabetic nephropathy

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Sato, A; Tarnow, L; Parving, H H

1998-01-01

in normotensive type 1 diabetic patients with and without nephropathy. RESEARCH DESIGN AND METHODS: M-mode and Doppler echocardiography was performed in 17 type 1 diabetic patients with nephropathy (albuminuria [median (range)], 345 (135-2,846) mg/24 h) and compared with 34 normotensive, normoalbuminuric (10 [3......-30] mg/24 h) type 1 diabetic patients matched for arterial blood pressure (mean +/- SD) ([134/77] +/- [13/7] vs. [129/78] +/- [12/7] mmHg), age (40 +/- 11 vs. 42 +/- 10 years), duration of diabetes (28 +/- 7 vs. 28 +/- 6 years), and BMI (24.2 +/- 4.2 vs. 24.6 +/- 2.4 kg/m2). RESULTS: Left ventricular......OBJECTIVE: Diabetic nephropathy increases the risk of premature cardiovascular disease and sudden death, particularly in type 1 diabetic patients. One possible mechanism for this risk may be left ventricular hypertrophy. In our study, we aimed to evaluate left ventricular structure and function...

What is hypertension in diabetes?

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Hansen, K W; Poulsen, P L; Ebbehøj, E

2001-01-01

AIMS: To establish reference data for ambulatory blood pressure (AMBP) in normotensive, normoalbuminuric Type 1 diabetic patients and characterize the relation to clinic blood pressure (BP). To evaluate the statement of the third working party of the British Hypertension Society (BHS) that a target...... clinic BP in diabetes diabetic patients, who had never received anti-hypertensive drugs. Clinic BP was determined as the mean of at least three auscultatory...

Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Jordan.

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Bakkar, May M; Haddad, Mera F; Gammoh, Yazan S

2017-01-01

Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate awareness of diabetic retinopathy among a sample of type 2 diabetes mellitus patients in Jordan. The study period was from August to December 2015. The sample was selected randomly from patients with type 2 diabetes mellitus from the general population in three main cities of Jordan (Amman, Irbid, and Zarqa). A questionnaire was distributed to 237 participants with diabetes to assess their awareness and knowledge of diabetes and diabetic retinopathy. The questionnaire included questions to assess awareness about diabetic retinopathy, sources of knowledge about the disease, and patients' knowledge and compliance with available treatments and routine eye examinations. Patients were also questioned about the barriers that may interfere with early eye examination. A total of 237 participants (107 [45.1%] females and 130 [54.9%] males) with type 2 diabetes were interviewed. Mean age±SD for the study population was 54.51±10.28 years. Of the study population, 88.2% were aware that diabetes can affect the eyes and 81% reported that diabetic retinopathy can lead to blindness. Higher level of patients' awareness of diabetic retinopathy was related to higher level of formal education ( p diabetic retinopathy as reported by 47.3% patients was general practitioners. Patients' compliance with diabetes management was relatively high; however, their compliance with routine retinal assessment was poor, with only a total of 29.5% of participants having had an eye examination in the previous year. Awareness of the nature and consequences of diabetic retinopathy among patients with diabetes in Jordan is relatively high. However, patients' motivation to undergo retinal assessment was poor in the sample, thus hindering early diagnosis and management.

Phytopharmacological evaluation of Byesukar for hypoglycaemic activity and its effect on lipid profile and hepatic enzymes of glucose metabolism in diabetic rats.

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Guruvayoorappan, C; Sudha, G

2008-01-01

Many anti-diabetic herbal preparations have been recommended in alternative systems of medicine for the treatment of diabetes. No systematic study has been done on the anti-diabetic efficacy of Byesukar, a polyherbal formulation to treat diabetes. The anti-diabetic efficacy of byesukar ethanol extract was evaluated in an animal model of diabetes induced by alloxan. Male Wistar rats were divided in to four groups. Group 1 was normal control group; group 2 and 3 received alloxan. After inducing experimental diabetes group 2 served as diabetic control; group 3 received byesukar (500 mg/kg body weight) orally for 30 consecutive days. Group 4 were normal rats which received byesukar extract alone. The effect of byesukar on glucose level in diabetic rats was studied and the level of glucose metabolizing enzymes (Hexokinase, glucose-6-phosphatase and fructose 1, 6-bisphosphatase) in the liver and kidney were estimated. The effect of byesukar on the serum and tissue lipid profile (Cholesterol, triglycerides, phospholipids and free fatty acids) were also estimated in diabetic rats. Our results indicate that treatment with byesukar resulted in significant reduction of blood glucose, tissue glucose-6-phosphatase and fructose 1, 6- bisphosphatase activity. The decreased tissue hexokinase activity in diabetes state was found to be significantly increased by byesukar treatment. Also the byesukar treated diabetic rats showed a significant decrease in the tissue lipid profile compared to the diabetic rats. In conclusion the decreased blood glucose accompanied with decreased lipid profile and changes in the activities of the glucose metabolizing enzymes shows the antidiabetic effect of byesukar.

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 ...

Evaluation of PMI-5011, an ethanolic extract of Artemisia dracunculus L., on peripheral neuropathy in streptozotocin-diabetic mice.

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Watcho, Pierre; Stavniichuk, Roman; Tane, Pierre; Shevalye, Hanna; Maksimchyk, Yury; Pacher, Pal; Obrosova, Irina G

2011-03-01

We previously reported that PMI-5011, an ethanolic extract of Artemisia dracunculus L., alleviates peripheral neuropathy in high fat diet-fed mice, a model of prediabetes and obesity developing oxidative stress and pro-inflammatory changes in the peripheral nervous system. This study evaluated PMI-5011 on established functional, structural, and biochemical changes associated with Type I diabetic peripheral neuropathy. C57Bl6/J mice with streptozotocin-induced diabetes of a 12-week duration, developed motor and sensory nerve conduction velocity deficits, thermal and mechanical hypoalgesia, tactile allodynia, and intra-epidermal nerve fiber loss. PMI-5011 (500 mg/kg/day for 7 weeks) alleviated diabetes-induced nerve conduction slowing, small sensory nerve fiber dysfunction, and increased intra-epidermal nerve fiber density. PMI-5011 blunted sciatic nerve and spinal cord 12/15-lipoxygenase activation and oxidative-nitrosative stress, without ameliorating hyperglycemia or reducing sciatic nerve sorbitol pathway intermediate accumulation. In conclusion, PMI-5011, a safe and non-toxic botanical extract, may find use in the treatment of diabetic peripheral neuropathy.

Metabolic Disorders and Diabetic Complications in Spontaneously Diabetic Torii Leprfa Rat: A New Obese Type 2 Diabetic Model

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Yusuke Kemmochi

2013-01-01

Full Text Available Spontaneously Diabetic Torii Leprfa (SDT fatty rat, established by introducing the fa allele of the Zucker fatty rat into SDT rat genome, is a new model of obese type 2 diabetes. Both male and female SDT fatty rats show overt obesity, and hyperglycemia and hyperlipidemia are observed at a young age as compared with SDT rats. With early incidence of diabetes mellitus, diabetic complications, such as nephropathy, retinopathy, and neuropathy, in SDT fatty rats were seen at younger ages compared to those in the SDT rats. In this paper, we overview pathophysiological features in SDT fatty rats and also describe new insights regarding the hematology, blood pressure, renal complications, and sexual dysfunction. The SDT fatty rats showed an increase of leukocytes, especially the monocyte count, prominent hypertension associated with salt drinking, end-stage renal disease with aging, and hypogonadism. Unlike other diabetic models, the characteristic of SDT fatty rat is to present an incidence of diabetes in females, hypertension, and retinopathy. SDT fatty rat is a useful model for analysis of various metabolic disorders and the evaluation of drugs related to metabolic disease.

Clinical and metabolic evaluation of one-stage, full-mouth, ultrasonic debridement as a therapeutic approach for uncontrolled type 2 diabetic patients with periodontitis.

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Cirano, Fabiano Ribeiro; Pera, Claudia; Ueda, Paulo; Casarin, Renato Correa Viana; Ribeiro, Fernanda Vieira; Pimentel, Suzana Peres; Casati, Marcio Zaffalon

2012-09-01

To evaluate the therapeutic potential of one-stage, full-mouth, ultrasonic debridement (FMUD) as a treatment for type 2 diabetic patients with generalized severe chronic periodontitis. Sixteen patients diagnosed with generalized severe chronic periodontitis and type 2 diabetes mellitus were allocated to the diabetic group; another 15 subjects with periodontitis but without metabolic disorders were placed in the nondiabetic group. Both groups were treated using the FMUD protocol, a unique 45-minute session of ultrasonic debridement of all sites presenting periodontal disease. Patients were analyzed for the following parameters: plaque and bleeding indices, gingival recession, probing depth, and clinical attachment level. Further, diabetic subjects were assessed using fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) tests. Patients were evaluated at 3 and 6 months for all parameters. ANOVA and the Tukey test were used for data analysis (P periodontal health after treatment. There were no significant differences between the groups for any of the parameters assessed (P > .05). Diabetic subjects treated with FMUD had a clinical response similar to that of nondiabetic subjects at all pocket depths. No adverse effects or medical disturbances were observed in either group during treatment. FPG and HbA1c levels remained unaltered after treatment. Within the limitations of this study, FMUD promoted clinical improvements in patients with type 2 uncontrolled diabetes and generalized severe chronic periodontitis.

Design of a trial to evaluate the impact of clinical pharmacists and community health promoters working with African-Americans and Latinos with Diabetes

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Gerber Ben S

2012-10-01

Full Text Available Abstract Background Given the increasing prevalence of diabetes and the lack of patients reaching recommended therapeutic goals, novel models of team-based care are emerging. These teams typically include a combination of physicians, nurses, case managers, pharmacists, and community-based peer health promoters (HPs. Recent evidence supports the role of pharmacists in diabetes management to improve glycemic control, as they offer expertise in medication management with the ability to collaboratively intensify therapy. However, few studies of pharmacy-based models of care have focused on low income, minority populations that are most in need of intervention. Alternatively, HP interventions have focused largely upon low income minority groups, addressing their unique psychosocial and environmental challenges in diabetes self-care. This study will evaluate the impact of HPs as a complement to pharmacist management in a randomized controlled trial. Methods/Design The primary aim of this randomized trial is to evaluate the effectiveness of clinical pharmacists and HPs on diabetes behaviors (including healthy eating, physical activity, and medication adherence, hemoglobin A1c, blood pressure, and LDL-cholesterol levels. A total of 300 minority patients with uncontrolled diabetes from the University of Illinois Medical Center ambulatory network in Chicago will be randomized to either pharmacist management alone, or pharmacist management plus HP support. After one year, the pharmacist-only group will be intensified by the addition of HP support and maintenance will be assessed by phasing out HP support from the pharmacist plus HP group (crossover design. Outcomes will be evaluated at baseline, 6, 12, and 24 months. In addition, program and healthcare utilization data will be incorporated into cost and cost-effectiveness evaluations of pharmacist management with and without HP support. Discussion The study will evaluate an innovative, integrated

Diabetes mellitus and Parkinson disease.

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Pagano, Gennaro; Polychronis, Sotirios; Wilson, Heather; Giordano, Beniamino; Ferrara, Nicola; Niccolini, Flavia; Politis, Marios

2018-05-08

To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease. We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline. The presence of diabetes mellitus was associated with higher motor scores ( p Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding ( p Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype. © 2018 American Academy of Neurology.

Dermatoses em pacientes com diabetes mellitus Skin lesions in diabetic patients

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N T Foss

2005-08-01

relationship with metabolic control of diabetes. METHODS: A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin. RESULTS: High number of dermophytosis (82.6% followed by different types of skin lesions such as acne and actinic degeneration (66.7%, pyoderma (5%, cutaneous tumors (3% and necrobiosis lipoidic (1% were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%, diabetic dermopathy (5 cases, 1.2% and foot ulcerations (3 cases, 0.7%. Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. A higher prevalence of dermatophytoses was seen in the both groups with inadequate metabolic control. CONCLUSIONS: The results showed a high prevalence of skin lesions in diabetic patients, especially dermatophytoses. Thus, poor metabolic control of diabetes increases patient's susceptibility to skin infections.

Association between Diabetic Polyneuropathy and Cardiovascular Complications in Type 2 Diabetic Patients

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Jin Ook Chung

2011-08-01

Full Text Available BackgroundDiabetes mellitus is a major independent risk factor for cardiovascular disease (CVD, but high cardiovascular risk in diabetes mellitus patients is not completely explained by clustering traditional risk factors. Recently, associations between diabetic polyneuropathy (DPN and macrovasculopathy have been suggested. We aimed to assess associations between DPN and cardiovascular complications in type 2 diabetic patients.MethodsMicrovascular and cardiovascular complications were evaluated in 1,041 type 2 diabetic patients.ResultsIn patients with DPN, the age, prevalence of hypertension, diabetes duration, systolic blood pressure, pulse pressure, and hemoglobin glycation (HbA1c levels were significantly higher, while the high density lipoprotein cholesterol (HDL-C levels were lower than in those without DPN. The prevalence of CVD was higher in patients with DPN. In multivariate analysis, DPN was independently associated with CVD (odds ratio, 1.801; 95% confidence interval, 1.009 to 3.214.ConclusionOur results showed that DPN was associated with a high prevalence of cardiovascular disease in type 2 diabetic patients, but further studies are needed to investigate the causative nature of associations between DPN and CVD.

Evaluation of the anti-diabetic properties of Mucuna pruriens seed extract.

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Majekodunmi, Stephen O; Oyagbemi, Ademola A; Umukoro, Solomon; Odeku, Oluwatoyin A

2011-08-01

To explore the antidiabetic properties of Mucuna pruriens(M. pruriens). Diabetes was induced in Wistar rats by single intravenous injection of 120 mg/kg of alloxan monohydrate and different doses of the extract were administered to diabetic rats. The blood glucose level was determined using a glucometer and results were compared with normal and untreated diabetic rats. The acute toxicity was also determined in albino mice. Results showed that the administration of 5, 10, 20, 30, 40, 50, and 100 mg/kg of the crude ethanolic extract of M. pruriens seeds to alloxan-induced diabetic rats (plasma glucose > 450 mg/dL) resulted in 18.6%, 24.9%, 30.8%, 41.4%, 49.7%, 53.1% and 55.4% reduction, respectively in blood glucose level of the diabetic rats after 8h of treatment while the administration of glibenclamide (5 mg/kg/day) resulted in 59.7% reduction. Chronic administration of the extract resulted in a significant dose dependent reduction in the blood glucose level (Ppruriens seeds resides in the methanolic and ethanolic fractions of the extract. Acute toxicity studies indicated that the extract was relatively safe at low doses, although some adverse reactions were observed at higher doses (8-32 mg/kg body weight), no death was recorded. Furthermore, oral administration of M. pruriens seed extract also significantly reduced the weight loss associated with diabetes. The study clearly supports the traditional use of M. pruriens for the treatment of diabetes and indicates that the plant could be a good source of potent antidiabetic drug. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Plasma lipoprotein(a levels: a comparison between diabetic and non-diabetic patients with acute ischemic stroke

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Holanda Maurus Marques de Almeida

2004-01-01

Full Text Available OBJECTIVE: The aim of this study was to evaluate lipoprotein(a (Lp(a, total cholesterol, high density lipoprotein cholesterol (HDL, low density lipoprotein cholesterol (LDL, very low density lipoprotein cholesterol (VLDL , triglycerides , apolipoprotein A (apo A and B100 (apo B100, uric acid, glycaemic and insulin plasmatic concentrations in patients affected by acute stroke. In this group of patients, we have compared the variables between type 2 diabetic patients and non-diabetic patients. METHOD: We evaluate a total of 34 non-diabetic patients (22 males and 12 females; mean age 66.71 ± 10.83 years and a group of 26 type 2 diabetic patients (15 males and 11 females; mean age 66.35 ± 9.92 years in a cross-sectional study. RESULTS: Mean Lp(a concentration did not significantly differ between type 2 diabetic patients and non-diabetic subjects (29.49 ± 23.09 vs 44.81 ± 44.34 mg/dl. The distribution of Lp(alevels was highly skewed towards the higher levels in both groups, being over 30 mg/dl in 50%. Lp(a concentration was positively correlated with abdominal adiposity, using waist-hip ratio(WHR(p< 0.05. No association was found between Lp(a and others risk factors like sex, age, other lipidic parameters and the presence of stroke. CONCLUSIONS: Our results showed that there were no significant differences between diabetic and non-diabetic patients' serum Lp(a levels, which indicates that elevated Lp(a levels were associated with ischemic stroke, irrespective of the presence of type 2 diabetes mellitus (type 2 DM.

A review of the literature: evaluating dietary intake of Filipino Americans at risk for type 2 diabetes.

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Brooks, Mirella Vasquez; Leake, Anne; Parsons, Charlotte; Pham, Valynn

2012-01-01

The purpose of this literature review is to investigate the research on the dietary intake of Filipino Americans. Evaluating the dietary practices of Filipino Americans may have an effect on the development of type 2 diabetes. Data collection was obtained, and four databases were included: Pub Medical, Cumulative Index of Nursing and Allied Health Literature, Journals at OVID, and Medline. The key words used in the search were "diet,"type 2 diabetes," and "Filipinos." A total of nine articles were relevant and met the inclusion criteria. The following articles were excluded: studies in a foreign language, letters to the editor, and program descriptions. © 2012 Wiley Periodicals, Inc.

Subclinical hypothyroidism and diabetic nephropathy in Iranian patients with type 2 diabetes.

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Mansournia, N; Riyahi, S; Tofangchiha, S; Mansournia, M A; Riahi, M; Heidari, Z; Hazrati, E

2017-03-01

Association of subclinical hypothyroidism with type 2 diabetes and its complications has been previously documented. These reports were, however, inconclusive and mainly gathered from Chinese and East Asian populations. In this study, we aimed to determine the prevalence of subclinical hypothyroidism and its relationship with diabetic nephropathy in Iranian individuals with type 2 diabetes, drawn from a white Middle Eastern population with an increasing prevalence of diabetes. In this cross-sectional study, 255 Iranian participants with type 2 diabetes and without history of thyroid disorders were included. Patients with TSH > 4.2 mIU/L and normal T4 were classified as having subclinical hypothyroidism. Diabetic nephropathy was diagnosed based on abnormal 24-h urinary albumin or protein measurements (24-h urinary albumin ≥30 mg/day or 24-h urinary protein ≥150 mg/day). Multivariate logistic regression was employed to obtain the OR for the relationship between subclinical hypothyroidism and diabetic nephropathy. We found that subclinical hypothyroidism and diabetic nephropathy were as prevalent as 18.1 and 41.2 %, respectively, among the participants. We also found that subclinical hypothyroidism was independently associated with higher rates of diabetic nephropathy, after multivariable adjustment (OR [95 % CI] 3.23 [1.42-7.37], p = 0.005). We found that the prevalence of subclinical hypothyroidism in Iranian diabetic population was among the highest rates reported to date. Our data supported the independent association of subclinical hypothyroidism with diabetic nephropathy, calling for further investigations to evaluate their longitudinal associations.

Evaluation of the uses of aspirin, statins and ACEIs/ARBs in a diabetes outpatient population in southern Thailand.

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Pongwecharak, J; Maila-ead, C; Sakulthap, J; Sripanitkulchai, N

2007-04-01

To evaluate the uses of aspirin, statins and angiotensin converting enzymes inhibitors/angiotensin receptor blockers (ACEIs/ARBs) in a diabetes population in southern Thailand. A review of outpatient medical records at the diabetic clinics of the regional hospital (n=304) and a community hospital (n=313), and a review of pharmacy computerized diabetes prescribing data (n=398) of the teaching hospital. All were in the province of Songkhla, southern Thailand. A total of 1015 diabetes patients, mean age (SD) 60.1 (12.1) years, were identified, with type 2 diabetes being most prevalent (93%). Females constituted 69%. Hypertension was a co-morbidity in almost half. Mean time (SD) since diagnosis was 5.8 (4.7) years. Where lipid profiles were available, less than one-third achieved the target LDL-C of <2.6 mmol L(-1). Almost all patients (96%) were candidates for treatment with a statin according to the American Diabetes Association (ADA) recommendation, whereas only 6.6 and 38.5% were actually taking one in the regional and the teaching hospital, respectively. Over 90% should have been taking primary prophylactic aspirin, whereas only 5.7-29% were actually prescribed one. A few had existing cardiovascular/cerebrovascular disease, and all were taking aspirin. There was no documented proteinuria status; however, 30-50% were on a ACEI/ARB, most likely as part of an antihypertensive regimen. Aspirin as a primary prophylaxis of cardiovascular disease in diabetes is remarkably underused. Screening for albuminuria was apparently lacking. Statin therapy also presented a major deficiency. ACEI/ARB was probably prescribed for hypertension rather than in relation to proteinuria.

Urinary Neutrophil Gelatinase-Associated Lipocalin and Progression of Diabetic Nephropathy in Type 1 Diabetic Patients in a Four-Year Follow-Up Study

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Nielsen, Stine Elkjaer; Hansen, Henrik Post; Jensen, Berit Ruud

2010-01-01

Background: Neutrophil gelatinase-associated lipocalin (NGAL), a marker of renal tubular damage, predicts progression in non-diabetic chronic kidney. We evaluated urinary (u)-NGAL as a predictor of progression in diabetic nephropathy in type 1 diabetic (T1D) patients. Methods: As a substudy of a 4......-year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly measurements of u-NGAL (ELISA, BioPorto). Outcome: Decline in glomerular filtration rate (GFR) ((51)Cr-EDTA), and end-stage renal disease (ESRD) or death...

Evaluation of pharmacists' educational and counselling impact on patients' clinical outcomes in a diabetic setting

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Winifred Aitalegbe Ojieabu

2017-01-01

Full Text Available Background: Nigeria had the highest number of people living with diabetes mellitus in the African region in year 2013. Previous researchers have found that patients with knowledge of their diseases including their treatment methods have a high likelihood to succeed in managing the disease conditions. Many pharmaceutical care programmes which have been successfully applied in various countries to enhance clinical outcomes and health-related quality of life are not very common in Nigeria. Objective: This study was to evaluate pharmacist's educational and counselling impact on diabetic patients' outcomes in a diabetic setting. Materials and Methods: The 4-month randomised controlled study involved 150 elderly Type 2 diabetic patients. Sociodemographic and clinical parameters were measured. We educated and counselled the 75 patients in our intervention group at least four times during the study period, but the control group was deprived of the pharmacist's intervention. Results: Female to male participants was in the ratio of 9:6 and 9:5 in both control and intervention groups, respectively. Majority (>40% of the patients in both groups had primary education. Baseline and 4-month mean fasting blood sugar in the control group was 162.2 ± 69.1 and 159.9 ± 57.2, respectively (P = 0.825, whereas the intervention group had 156.7 ± 30.5 and 131.8 ± 40.4, respectively (P < 0.001. Mean systolic blood pressure in both groups was 146.4 ± 13.9 and 133.8 ± 18.5 (P < 0.001, respectively. Adherence levels to medication taking in both groups were 42.7%:94.7%, respectively (P = 0.001. Conclusion: This study encourages the inclusion of clinical pharmacists into multidisciplinary healthcare groups in hospital and clinic settings as well as incorporation of this type of intervention into diabetic management programmes for optimal patients' outcomes.

An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey

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Yosi Wibowo

2015-12-01

Full Text Available Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient’s own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients’ views have been limited to developed countries.Objectives. To investigate, within a developing country setting (Indonesia, current use of pharmacy services by type 2 diabetes patients, and to evaluate their views regarding community pharmacists’ roles, and the characteristics that influence their views.Methods. A questionnaire survey was conducted within 10 purposefully selected community pharmacies in Surabaya, Indonesia. Each pharmacy recruited approximately 20 patients seeking antidiabetic medications. Usage of pharmacy services was identified using binary responses (‘yes’/‘no’ and views on pharmacists’ roles were rated using Likert scales; an open-ended question was used to identify patient perceived priority roles. Logistic regression models were used to determine characteristics associated with patients’ views.Results. A total of 196 pharmacy patients with type 2 diabetes responded (58.3% response rate. Most patients used community pharmacies for dispensing (100% and education on how to use medications (79.6%. There were mixed views towards pharmacists providing services beyond dispensing. The highest priorities identified were from the ‘patient education’ domain: education on medications (i.e., directions for use (64.5%, storage (26.6%, common/important adverse effects (25.5%; and the ‘monitoring’ domain: monitoring medication compliance (37.3%. Patients with higher incomes or who were working were less supportive of these expanded services

Treatment Modality-Dependent Risk of Diabetic Ketoacidosis in Patients with Type 1 Diabetes

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Hoshina, Sari; Andersen, Gregers S; Jørgensen, Marit E

2018-01-01

BACKGROUND AND AIMS: The aim of this study was to evaluate the incidence rates of diabetic ketoacidosis (DKA) according to treatment modality in patients with type 1 diabetes (T1D) in Denmark, either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). MATERIALS AND...... events were lower among CSII users, while the opposite was true for the smaller clinics (P = 0.016). CONCLUSIONS: Delivery of CSII in large diabetes clinics with sufficient support and patient education may ensure that CSII treatment does not lead to an increased risk of DKA....

Cognitive function in adult offspring of women with Type 1 diabetes

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Clausen, Tine Dalsgaard; Mortensen, E L; Schmidt, L

2011-01-01

Maternal diabetes may affect offspring cognitive function. The objective of the study was to evaluate cognitive function and potential predictors hereof in adult offspring of women with Type 1 diabetes.......Maternal diabetes may affect offspring cognitive function. The objective of the study was to evaluate cognitive function and potential predictors hereof in adult offspring of women with Type 1 diabetes....

Cytokine ratios in chronic periodontitis and type 2 diabetes mellitus.

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Acharya, Anirudh B; Thakur, Srinath; Muddapur, M V; Kulkarni, Raghavendra D

Chronic periodontitis may influence systemic cytokines in type 2 diabetes. This study aimed to evaluate the cytokine ratios in type 2 diabetes with, and without chronic periodontitis. Gingival status, periodontal, glycemic parameters and serum cytokines were evaluated in participants grouped as healthy, chronic periodontitis, and type 2 diabetes with, and without chronic periodontitis. Cytokine ratios showed significant differences in type 2 diabetes and chronic periodontitis, were highest in participants having both type 2 diabetes and chronic periodontitis, with a statistically significant cut-off point and area under curve by receiver operating characteristic. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

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Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill

2013-01-01

Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859

The evaluation of off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) randomized controlled trial: study design and rational.

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Mohammedi, Kamel; Potier, Louis; François, Maud; Dardari, Dured; Feron, Marilyne; Nobecourt-Dupuy, Estelle; Dolz, Manuel; Ducloux, Roxane; Chibani, Abdelkader; Eveno, Dominique-François; Crea Avila, Teresa; Sultan, Ariane; Baillet-Blanco, Laurence; Rigalleau, Vincent; Velho, Gilberto; Tubach, Florence; Roussel, Ronan; Dupré, Jean-Claude; Malgrange, Dominique; Marre, Michel

2016-01-01

Off-loading is essential for diabetic foot management, but remains understudied. The evaluation of Off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) trial aims to evaluate the efficacy of a new removable device "Orthèse Diabète" in the healing of diabetic foot. ORTHODIAB is a French multi-centre randomized, open label trial, with a blinded end points evaluation by an adjudication committee according to the Prospective Randomized Open Blinded End-point. Main endpoints are adjudicated based on the analysis of diabetic foot photographs. Orthèse Diabète is a new removable off-loading orthosis (PROTEOR, France) allowing innovative functions including real-time evaluation of off-loading and estimation of patients' adherence. Diabetic patients with neuropathic plantar ulcer or amputation wounds (toes or transmetatarsal) are assigned to one of 2 parallel-groups: Orthèse Diabète or control group (any removable device) according to a central computer-based randomization. Study visits are scheduled for 6 months (days D7 and D14, and months M1, M2, M3, and M6). The primary endpoint is the proportion of patients whose principal ulcer is healed at M3. Secondary endpoints are: the proportion of patients whose principal ulcer is healed at M1, M2 and M6; the proportion of patients whose initial ulcers are all healed at M1, M2, M3, and M6; principal ulcer area reduction; time-related ulcer-free survival; development of new ulcers; new lower-extremity amputation; infectious complications; off-loading adherence; and patient satisfaction. The study protocol was approved by the French National Agency for Medicines and Health Products Safety, and by the ethics committee of Saint-Louis Hospital (Paris). Comprehensive study information including a Patient Information Sheet has been provided to each patient who must give written informed consent before enrolment. Monitoring, data management, and statistical analyses are providing by UMANIS Life Science (Paris

Relations between Resiliency, Diabetes-Related Quality of Life, and Disease Markers to School-Related Outcomes in Adolescents with Diabetes

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Perfect, Michelle M.; Jaramillo, Evelyn

2012-01-01

The current study examined the role that resiliency and diabetes quality of life play in school functioning and glucose control among adolescents with diabetes. Participants included 45 adolescents with diabetes who participated in a larger study evaluating the feasibility of a model of mental health screening, assessment, and referral/service…

Association between type 2 diabetes mellitus and disability: What is the contribution of diabetes risk factors and diabetes complications?

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Tabesh, Maryam; Shaw, Jonathan E; Zimmet, Paul Z; Söderberg, Stefan; Koye, Digsu N; Kowlessur, Sudhir; Timol, Maryam; Joonas, Noorjehan; Sorefan, Ameena; Gayan, Praneel; Alberti, K George M M; Tuomilehto, Jaakko; Magliano, Dianna J

2018-03-06

The aim of this study was to evaluate the association between type 2 diabetes and disability in Mauritius and to assess the extent to which the effect of diabetes is explained by diabetes risk factors and concomitant complications. Data from a national survey in the multiethnic nation of Mauritius, which comprises South Asians and African Creoles, were analyzed. Disability was measured using the Katz activities of daily living questionnaire in participants aged >50 years. Among 3692 participants, 487 (13.2%) had some level of disability. Diabetes was associated with significantly higher risk of disability (odds ratio [OR] 1.67; 95% confidence interval [CI] 1.34-2.08). After adjusting for demographic, behavioral, and metabolic factors, as well as comorbidities, disability was significantly associated with diabetes among African Creoles (OR 2.03; 95% CI 1.16-3.56), but not South Asians (OR 1.27; 95% CI 0.98-1.66). Obesity explained much of the association between diabetes and disability (excess percentage of risk: 26.3% in South Asians and 12.1% in African Creoles). Obesity, history of cardiovascular disease (CVD), asthma-like symptoms, and depression together explained 46.5% and 29.0% of the excess risk in South Asians and African Creoles, respectively. Diabetes is associated with a 67% increased risk of disability. Diabetes risk factors and comorbidities explain more of the association between diabetes and disability among South Asians than Africans. Obesity and history of CVD explained the largest percentage of the relationship between diabetes and disability, indicating that weight and CVD management may be helpful in controlling disability related to diabetes. © 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Evaluation of antihyperglycaemic activity of Calotropis procera leaves extract on streptozotocin-induced diabetes in Wistar rats

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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.

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

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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.

[Diabetic retinopathy during pregnancy.

DEFF Research Database (Denmark)

Mathiesen, E.R.; Rasmussen, K.L.; Laugesen, C.S.

2008-01-01

INTRODUCTION: The aim was to evaluate the prevalence and progression of diabetic retinopathy during pregnancy in women with type 1 or type 2 diabetes. MATERIAL AND METHODS: Dilated fundal photography was performed at approximately 10 and 28 gestational weeks in 58 and 18 women with type 1 and type...... 2 diabetes, respectively. Retinopathy was classified as five stages +/- macular oedema. Progression was defined as deterioration corresponding to at least one stage between the two examinations. Clinical parameters were obtained from the medical records. RESULTS: Diabetic retinopathy was found in 36...... (62%) women with type 1 and three (17%) with type 2 diabetes at the first examination. In 26 (34%) retinopathy progressed; four women developed proliferations, three macular oedema and three reduction of visual acuity >/=0.2 on Snellen's chart in at least one eye. HbA1c in early pregnancy was the only...

Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis

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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 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

Predictors of mortality in insulin dependent diabetes

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Rossing, P; Hougaard, P; Borch-Johnsen, K

1996-01-01

OBJECTIVE: To evaluate the prognostic significance of microalbuminuria and overt diabetic nephropathy and other putative risk factors for cardiovascular and all cause mortality in insulin dependent diabetes. DESIGN: Ten year observational follow up study. SETTING: Outpatient diabetic clinic...... in a tertiary referral centre. SUBJECTS: All 939 adults with insulin dependent diabetes (duration of diabetes five years or more) attending the clinic in 1984; 593 had normal urinary albumin excretion ( or = 300 mg...... and other potentially modifiable risk factors such as hypertension, smoking, poor glycaemic control, and social class predict increased mortality in insulin dependent diabetes. Microalbuminuria by itself confers only a small increase in mortality. The prognosis of patients with overt diabetic nephropathy...

Development and Validation of a Deep Learning System for Diabetic Retinopathy and Related Eye Diseases Using Retinal Images From Multiethnic Populations With Diabetes.

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Ting, Daniel Shu Wei; Cheung, Carol Yim-Lui; Lim, Gilbert; Tan, Gavin Siew Wei; Quang, Nguyen D; Gan, Alfred; Hamzah, Haslina; Garcia-Franco, Renata; San Yeo, Ian Yew; Lee, Shu Yen; Wong, Edmund Yick Mun; Sabanayagam, Charumathi; Baskaran, Mani; Ibrahim, Farah; Tan, Ngiap Chuan; Finkelstein, Eric A; Lamoureux, Ecosse L; Wong, Ian Y; Bressler, Neil M; Sivaprasad, Sobha; Varma, Rohit; Jonas, Jost B; He, Ming Guang; Cheng, Ching-Yu; Cheung, Gemmy Chui Ming; Aung, Tin; Hsu, Wynne; Lee, Mong Li; Wong, Tien Yin

2017-12-12

A deep learning system (DLS) is a machine learning technology with potential for screening diabetic retinopathy and related eye diseases. To evaluate the performance of a DLS in detecting referable diabetic retinopathy, vision-threatening diabetic retinopathy, possible glaucoma, and age-related macular degeneration (AMD) in community and clinic-based multiethnic populations with diabetes. Diagnostic performance of a DLS for diabetic retinopathy and related eye diseases was evaluated using 494 661 retinal images. A DLS was trained for detecting diabetic retinopathy (using 76 370 images), possible glaucoma (125 189 images), and AMD (72 610 images), and performance of DLS was evaluated for detecting diabetic retinopathy (using 112 648 images), possible glaucoma (71 896 images), and AMD (35 948 images). Training of the DLS was completed in May 2016, and validation of the DLS was completed in May 2017 for detection of referable diabetic retinopathy (moderate nonproliferative diabetic retinopathy or worse) and vision-threatening diabetic retinopathy (severe nonproliferative diabetic retinopathy or worse) using a primary validation data set in the Singapore National Diabetic Retinopathy Screening Program and 10 multiethnic cohorts with diabetes. Use of a deep learning system. Area under the receiver operating characteristic curve (AUC) and sensitivity and specificity of the DLS with professional graders (retinal specialists, general ophthalmologists, trained graders, or optometrists) as the reference standard. In the primary validation dataset (n = 14 880 patients; 71 896 images; mean [SD] age, 60.2 [2.2] years; 54.6% men), the prevalence of referable diabetic retinopathy was 3.0%; vision-threatening diabetic retinopathy, 0.6%; possible glaucoma, 0.1%; and AMD, 2.5%. The AUC of the DLS for referable diabetic retinopathy was 0.936 (95% CI, 0.925-0.943), sensitivity was 90.5% (95% CI, 87.3%-93.0%), and specificity was 91.6% (95% CI, 91.0%-92.2%). For

Diabetic complications do not hamper improvement of health-related quality of life over the course of treatment of diabetic foot ulcers

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Siersma, Volkert; Thorsen, Hanne; Holstein, Per E.

2017-01-01

Aims: Diabetic complications, and in particular diabetic foot ulcers (DFUs), are associated with low health-related quality of life (HRQoL). We evaluated whether the presence of diabetic complications also influenced the improvement of HRQoL during DFU treatment. Methods: 1088 patients presenting...

Monitoring of psychological well-being in outpatients with diabetes

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Pouwer, F; Snoek, Frank J; Van Der Ploeg, Henk M

2001-01-01

OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: This study was a randomized controlled trial of 461...... outpatients with diabetes who were randomly assigned to standard care or to the monitoring condition. In the latter group, the diabetes nurse specialist assessed and discussed psychological well-being with the patient (with an interval of 6 months) in addition to standard care. The computerized Well...... nurse. The two groups did not differ for HbA(1c) or in their overall evaluation of the quality of diabetes care. In the monitoring condition, significantly more subjects were referred to the psychologist. CONCLUSIONS: Monitoring and discussing psychological well-being as part of routine diabetes...

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

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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.

MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

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Pierre-Jerome, Claude; Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R.

2012-01-01

Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor

MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

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Pierre-Jerome, Claude, E-mail: cpierr3@emory.edu [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States); Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R. [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States)

2012-10-15

Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor.

Association of Metformin Treatment with Reduced Severity of Diabetic Retinopathy in Type 2 Diabetic Patients

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Yue Li

2018-01-01

Full Text Available Purpose. To evaluate effects of long-term metformin on the severity of diabetic retinopathy (DR in high-risk type 2 diabetic (T2D patients. Methods. A retrospective chart review study was conducted involving 335 DR patients with T2D ≥ 15 years from 1990 to 2013. The severity of DR was determined by Early Treatment Diabetic Retinopathy Study scale. The associations between metformin and DR severity were evaluated. Comparison with stratification for the use of sulfonylurea and insulin was performed to identify possible confounding effects. Results. Severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy (SNPDR/PDR was more often diagnosed in nonmetformin users (67/142, 47% versus metformin users (48/193, 25% (p<0.001, regardless of gender and race of the patients. The odds ratio of metformin associated with SNPDR/PDR was 0.37 in all cases (p<0.001, 0.35 in sulfonylurea use cohort (p<0.05, 0.45 in nonsulfonylurea use cohorts (p<0.01, and 0.42 in insulin use cohort (p<0.01. Insulin users had a higher rate of SNPDR/PDR. Metformin had no influence on the occurrence of clinical significant diabetic macular edema. Conclusions. Long-term use of metformin is independently associated with a significant lower rate of SNPDR/PDR in patients with type 2 diabetes ≥ 15 years.

HbA1c as a predictor of diabetes after gestational diabetes mellitus.

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Claesson, Rickard; Ignell, Claes; Shaat, Nael; Berntorp, Kerstin

2017-02-01

We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM). Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis. By five years, 73 of 196 women had been diagnosed with diabetes. An optimal cut-off point for HbA1c of 36mmol/mol (5.4%) could predict diabetes with 45% sensitivity and 92% specificity. For HbA1c ≥39mmol/mol (≥5.7%), sensitivity, specificity, and positive predictive value were 30%, 97%, and 91%, respectively. In logistic regression analysis, adjusting for the diagnostic glucose concentration during pregnancy, HbA1c levels in the upper quartile (≥36mmol/mol) were associated with a 5.5-fold increased risk of diabetes. Third-trimester HbA1c levels in the pre-diabetes range revealed women with post-partum diabetes with high specificity and high positive predictive value. HbA1c testing could be used as a strategy to select high-risk women for lifestyle interventions aimed at prevention of diabetes starting during pregnancy. The results should encourage further validation in other populations using new diagnostic criteria for GDM. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Evaluation of the Zucker diabetic fatty (ZDF rat as a model for human disease based on urinary peptidomic profiles.

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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.

New Therapeutic Approaches in Diabetic Retinopathy

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Vaziri, Kamyar; Schwartz, Stephen G.; Relhan, Nidhi; Kishor, Krishna S.; Flynn Jr, Harry W.

2015-01-01

Diabetic retinopathy is a common microvascular complication of diabetes mellitus. It affects a substantial proportion of US adults over age 40. The condition is a leading cause of visual loss. Much attention has been given to expanding the role of current treatments along with investigating various novel therapies and drug delivery methods. In the treatment of diabetic macular edema (DME), intravitreal pharmacotherapies, especially anti-vascular endothelial growth factor (anti-VEGF) agents, have gained popularity. Currently, anti-VEGF agents are often used as first-line agents in center-involved DME, with recent data suggesting that among these agents, aflibercept leads to better visual outcomes in patients with worse baseline visual acuities. While photocoagulation remains the standard treatment for proliferative diabetic retinopathy (PDR), recent FDA approvals of ranibizumab and aflibercept in the management of diabetic retinopathy associated with DME may suggest a potential for pharmacologic treatments of PDR as well. Novel therapies, including small interfering RNAs, chemokines, kallikrein-kinin inhibitors, and various anti-angiogenic agents, are currently being evaluated for the management of diabetic retinopathy and DME. In addition to these strategies, novel drug delivery methods such as sustained-release implants and refillable reservoir implants are either under active evaluation or have recently gained FDA approval. This review provides an update on the novel developments in the treatment of diabetic retinopathy. PMID:26676668

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

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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.

Protective effect of melatonin in the diabetic rat retina.

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Mehrzadi, Saeed; Motevalian, Manijeh; Rezaei Kanavi, Mozhgan; Fatemi, Iman; Ghaznavi, Habib; Shahriari, Mansoor

2018-03-01

Diabetic retinopathy (DR) is one of the most common and serious microvascular complications of diabetes. The aim of this study was to evaluate the effects of melatonin (MEL) on retinal injury in diabetic rats. In this study, 21 rats were randomly divided into three groups: control, diabetic, and diabetic + MEL. Streptozotocin was used to induce diabetes at a dose of 50 mg/kg, i.p., and blood glucose was measured to choose the diabetic rats for the study. MEL (20 mg/kg) was given orally for 7 weeks in diabetic rats starting 1 week after induction of diabetes. After 8 weeks, the groups were compared in terms of mean scores of fluorescein leakage, using fluorescein angiography. Reactive oxygen species (ROS) and malondialdehyde (MDA) levels were estimated in retina using commercially available assays. Structural changes in retinas were evaluated by light microscopy. Results showed that diabetes significantly increased the mean scores of fluorescein leakage, and MDA and ROS levels compared to control group. Treatment of the diabetic rats with MEL for 7 weeks prevented the alterations induced by diabetes in comparison with the diabetic control group.Based on these findings, it can be concluded that MEL might have beneficial effects in prevention of DR. © 2018 Société Française de Pharmacologie et de Thérapeutique.

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.

Insulin therapy does not interfere with venous endothelial function evaluation in patients with type 2 diabetes mellitus.

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Silva, Antônio Marcos Vargas da; Penno, Luciana de Moraes; Bertoluci, Marcello Casaccia; Irigoyen, Maria Cláudia; Schaan, Beatriz D'Agord

2010-01-01

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. 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). 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). Subcutaneous insulin therapy does not interfere with venous endothelial function in type 2 diabetes when glycemic and blood pressure control are stable.

Anti-diabetic properties of Momordica charantia L. polysaccharide in alloxan-induced diabetic mice.

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Xu, Xin; Shan, Bin; Liao, Cai-Hu; Xie, Jian-Hua; Wen, Ping-Wei; Shi, Jia-Yi

2015-11-01

A water-soluble polysaccharide (MCP) was isolated from the fruits of Momordica charantia L., and the hypoglycemic effects of MCP were investigated in both normal healthy and alloxan-induced diabetic mice. MCP was orally administered once a day after 3 days of alloxan-induction at 100, 200 and 300mg/kg body weight for 28 day. Results showed that fasting blood glucose level (BGL) was significantly decreased, whereas the glucose tolerance was marked improvement in alloxan-induced diabetic mice, and loss in body weight was also prevented in diabetic mice compared to the diabetic control group. The dosage of 300mg/kg body weight exhibited the best effects. In addition, MCP did not exhibit any toxic symptoms in the limited toxicity evaluation in mice. The results suggest that MCP possess significantly dose-dependent anti-diabetic activity on alloxan-induced diabetic mice. Hence, MCP can be incorporated as a supplement in health-care food, drugs and/or combined with other hypoglycemic drugs. Copyright © 2015 Elsevier B.V. All rights reserved.

Physical activity and diabetes mellitus.

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Bhaskarabhatla, Krishna V; Birrer, Richard

2005-01-01

Diabetes mellitus (DM), a metabolic syndrome consisting of two main groups, type 1 and 2, is characterized by absolute or relative insulin deficiency or insulin resistance. Individuals with DM take part in physical activity for health promotion, disease management, and or recreational or competitive sports. Several studies confirm the beneficial role of physical activity in favorably altering the prognosis of DM. Exercise as a therapeutic strategy has potential risks, too. Hence, sports medicine physicians caring for athletes with diabetes have several important responsibilities. Diabetic education; pre-participatory evaluation for vascular, neurological, retinal or joint disease; diabetic status and control; promotion of blood glucose self-monitoring; and individualized dietary, medication, and physical activity plans are essential to achieve safe and enjoyable outcomes in individuals with diabetes who are embarking on physical activity.

Prevalence of hypertension amongst persons with diabetes mellitus ...

African Journals Online (AJOL)

Objective: To determine the prevalence of hypertension amongst persons with diabetes mellitus (DM) in Benin city. Materials and Methods: Four hundred and fifty diabetic subjects were evaluated for hypertension by measuring their blood pressure using a sphygmomanometer at the diabetes clinics of the University of Benin ...

Evaluating a School-Based Day Treatment Program for Students with Challenging Behaviors

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Hickman, Antoine Lewis

2014-01-01

Jade County Public Schools has provided school-based therapeutic day treatment in its public schools for more than 10 years. This program was adopted by the school system to provide an intervention in the school and classroom to address the challenging behaviors of students with emotional and behavioral disorders. Currently, three human services…

Prevalence of diabetic retinopathy in screening-detected diabetes mellitus: results from the Gutenberg Health Study (GHS).

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Ponto, Katharina A; Koenig, Jochem; Peto, Tunde; Lamparter, Julia; Raum, Philipp; Wild, Philipp S; Lackner, Karl J; Pfeiffer, Norbert; Mirshahi, Alireza

2016-09-01

Individuals with type 2 diabetes mellitus may experience an asymptomatic period of hyperglycaemia, and complications may already be present at the time of diagnosis. We aimed to determine the prevalence of diabetic retinopathy in patients with newly diagnosed (screening-detected) type 2 diabetes. The Gutenberg Health Study is a population-based study with 15,010 participants aged between 35 and 74 years. We determined the weighted prevalence of diabetic retinopathy by assessing fundus photographs. Screening-detected type 2 diabetes was defined as an HbA1c concentration of 6.5% (47.5 mmol/mol) or more, no medical diagnosis of diabetes and no intake of insulin or oral glucose-lowering agents. Of 14,948 participants, 1377 (9.2%) had diabetes mellitus. Of these, 347 (25.2%) had newly diagnosed type 2 diabetes detected by the screening. Overall, the weighted prevalence of screening-detected type 2 diabetes was 2.1%. Fundus photos were evaluable for 285 (82.1%) participants with newly diagnosed diabetes. The weighted prevalence of diabetic retinopathy in screening-detected type 2 diabetes was 13.0%; 12% of participants had a mild non-proliferative diabetic retinopathy and 0.6% had a moderate non-proliferative diabetic retinopathy. Diabetic retinopathy was proliferative in 0.3%. No cases of severe non-proliferative diabetic retinopathy or diabetic maculopathy were found. Thirty (14.9%) of 202 and six (7.2%) of 83 individuals with and without concomitant arterial hypertension, respectively, had diabetic retinopathy (OR 2.54, 95% CI 1.06, 7.14). Visual acuity did not differ between individuals with and without diabetic retinopathy . In this large European study, the prevalence of diabetic retinopathy in screening-detected type 2 diabetes was 13%. Only a very small proportion of participants with detected diabetic retinopathy needed treatment.

The application and evaluation of insulin release test and quantitative parameter in diabetic type II

International Nuclear Information System (INIS)

Huang Chenggang; Chen Xiaoyan; Guan Xiaofeng

2002-01-01

Objective: To analyse the curve of Insulin Release Test (IRT) about the patients whit type II diabetes, to evaluate β-cell function and the sensitivity of body to Insulin using Insulin Release Index (IRI) and Insulin Sensitivity Index (ISI), and to probe the value for clinical therapy. Methods: 1) Have a IRT of 396 cases with type II diabetes and 17 normal bodies and acquire the IRT curve, 2) Design the count methods about IRI and ISI, IRI = Ins max/Ins FBI x Δ Ins max/T max (minute), ISI=(Ins max-Ins FBI)/(Ins 180'-Ins FBI), 3) Compare IRI Changes of before and after treatment for 12 cases with no insulin release and 9 cases with less insulin release. Results: IRT curve type (No release type 21.0%, less release type 33.3%, peak delay type 36.9%, high insulin type 6.0%, release delay type 2.8%); respective IRI, ISI compared to normal, P<0.01; IRI of before and after treatment with insulin P<0.01. Conclusions: IRT Curve combining IRI and ISI can reflect accurately β-cell function with type II diabetes and the sensitivity of body to insulin, Also it has some reference value for clinical therapy

Chromium level in prediction of diabetes in pre-diabetic patients

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Rahmatollah Rafiei

2014-01-01

Full Text Available Background: Chromium supplementations (Cr have been shown to exert beneficial effects in the management of type-2 diabetes. Prevalence of Cr deficiency in pre-diabetic patients is not well-understood, therefore, the aim of this study was to evaluate the extent of this prevalence. Materials and Methods: In this cross-sectional descriptive study, 132 pre-diabetic patients were recruited. The participants were randomly selected from those who referred to the Shariati Hospital in Isfahan, Iran. Blood samples are collected for measurement of Cr, insulin, fasting blood sugar (FBS, and two-hour post-load plasma glucose. The body mass index (BMI was calculated. Determination of Cr was carried out by atomic absorption spectrometry. Results: Thirty-four (31.5% patients had Cr deficiency and 74 (68.5% patients had normal Cr. There was no significant difference between sex, age groups (<50 years and ≥50 years and between patients with and without a family history of diabetes in both the groups. No significant differences in age, BMI, FBS or insulin were observed between two groups. In the group with a normal level of Cr, there was a significant reversed correlation between the Cr level and age, but no significant correlation existed between the Cr level and other factors in both groups. Conclusion: The levels of Cr deficiency are relatively common in patients with pre-diabetes, and it is necessary to screen patients with diabetes and pre-diabetes according to the American Diabetes Association guidelines, with regard to the Cr level and action should be taken to eliminate the Cr deficiency in these patients.

EVALUATION OF MALE SEX HORMONES AND TRACE ELEMENTS IN MALE TYPE 2 DIABETIC PATIENTS ATTENDING NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL DIABETIC CLINICS.

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Ubajaka, C F; Meludu, S C; Dioka, C E; Onah, C E; Osuji, C U; Modebe, I A; Ifeadike, G C; Okwara, J E; Amah, U K; Nnebue, C C

2015-01-01

There is accumulating evidence that the metabolism of male sex hormones and several trace elements are altered in type 2 diabetic mellitus and may have specific role in the pathogenesis and progression of the disease. To assess the levels of male sex hormones and trace elements in type 2 diabetic patients and to ascertain an association between male sex hormones and trace elements among diabetic subjects. A descriptive cross sectional study was conducted among 125 diabetic and 50 non diabetic subjects. Venous blood samples were collected from all respondents and estimated for fasting blood glucose, male sex hormones and trace elements. The results were subjected to statistical analysis and comparison using Students' test and Pearson correlation analysis. The mean testosterone level was significantly lower in diabetics than in controls (3.9 ± 1.9ng/ml) in comparison with (5.1 ± 1.7ng/ml; P < 0.05). The mean value of Zinc, Manganese, Selenium and Chromium were significantly lower among the diabetics when compared with the controls (Zn;898.7 ± 131.0 μg/l; Mn:0.30 ± 0.06 μg/l;Se:51.3 ± 11.1 μg/l; Cr: 0.04 ± 0.03 μg/I) in comparison with (Zn: 1007.3 ± 85.2 μg/l; Mn: 0.05 ± 0.07μg/l; Se: 62.1 ± 11.1 μg/l; Cr: 0.06 ± 0.01 μg/l; P < 0.05).The mean Fasting Blood Glucose in diabetic subjects was significantly higher when compared with the controls (7.9 ± 3.7 mmol/l) in comparison with (4.6 ± 0.4 mmol/l; P < 0.05).The trace elements showed a positive correlation with testosterone in diabetic subjects (Zn r = 0.359, Ser = 0.443, Mn r = 0.350, P < 0.05). This study observed decreased levels of testosterone and trace elements in type 2 diabetics and a positive correlation between low testosterone and low trace elements levels in diabetic subjects. These trace elements are antioxidants and their low levels in diabetic patients may further increase the severity of the disease.

[Evaluation of the Global Research Architecture Regarding Diabetic Retinopathy].

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Schöffel, N; Wahrlich, N; Groneberg, D A; Bundschuh, M; Ohlendorf, D; Bendels, M H K

2017-02-01

Aims and Scope: Diabetic retinopathy (DR) is of major scientific and socioeconomic interest in most of the industrialized countries due to increasing prevalence. This interest is reflected by a marked increase in the number of publications since the 1990 s. It is therefore difficult for a single author to obtain an overview of the topic. Material and Methods: The total number of published items on DR was determined in the Web of Science database. All bibliometric data were collected for the period 1900 to 2008 (search term:"diabet* retinopath*" and "diabet* macul*"). A number of different scientometric methods were applied in accordance with the NewQIS protocol, e.g. state of the art visualisation techniques such as density equalising maps and network diagrams. Results: A total of 15,624 publications were identified. The U. S. A. leads in the overall number of publications (4,689). The most productive and the most prolific institutions, authors and publications are all in the U. S. A. The University of Wisconsin (i.e. Ronald Klein and his wife Barbara Eden Kobrin Klein) have established an international network with a large number of institutions publishing important work. Nevertheless, many other important institutions can be identified, e.g. the Joslin Diabetes Center, which has published many articles on VEGF. Conclusion: The results reveal that the scientific interest on the topic DR is continuously increasing. International collaboration is of growing importance in this field. Georg Thieme Verlag KG Stuttgart · New York.

Delayed progression of diabetic cataractogenesis and retinopathy by Litchi chinensis in STZ-induced diabetic rats.

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Kilari, Eswar Kumar; Putta, Swathi

2017-03-01

The study was carried out to evaluate the effect of the aqueous fruit pericarp extract of Litchi chinensis (APLC) on parameters which leads to diabetic cataractogenesis and retinopathy in the streptozotocin-induced diabetic rats. The objective of the study is to evaluate the APLC for in vivo antioxidant activity and its role in inhibiting the polyol pathway and formation of advanced glycation end products (AGEs). The diabetic animals were treated with L. chinensis for a period of 12 weeks. At the end of 12 weeks, the animals were killed and the biochemical pathways involved in the pathogenesis of cataract such as oxidative stress by protein content, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), and polyolpathway by aldose reductase (AR) in lens homogenates, alterations in protein carbonyl content (PCO) and AGEs in both serum and lens the APLC-treated diabetic rats were compared against diabetic control rats. Cataract progression due to hyperglycemia was monitored by slit lamp bio microscope and classified into four stages. Fundoscope test and retinal histopathology were done for assessing retinopathy. Statistically significant reduction in glucose, and elevation of protein content, SOD, CAT, and GSH levels and decreased levels of AR and PCO in lens homogenate and significant reduction in AGEs serum and lens homogenate were observed. Slit lamp examination, fundoscope, and histopathology showed improvement in retinal changes in APLC-treated rats compared to diabetic control animals. The treatment with APLC found to delay the progression of diabetic cataractogenesis and retinopathy, which might be due to its antioxidant activity, because of the presence of active phytochemicals in APLC.

CORRELATION OF HBA1C WITH SIGHT-THREATENING DIABETIC RETINOPATHY (STDR IN TYPE 2 DIABETES MELLITUS

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Ranjini Kotancher

2017-09-01

Full Text Available BACKGROUND Diabetic retinopathy is a major cause of blindness in the world with India being set to emerge as the diabetic capital of the world. Visual disability from diabetes is a significant health problem, but its morbidity is largely preventable and treatable. HbA1c (glycosylated haemoglobin is the best indicator of glycaemic control. It has long been known to predict the incidence and progression of diabetic retinopathy. Our aim is to evaluate the correlation of STDR in type 2 diabetes mellitus with HbA1c levels. MATERIALS AND METHODS A cross-sectional study was carried out in the Department of Ophthalmology, Government Medical College, Kozhikode, among 250 randomly selected type 2 Diabetes Mellitus patients and they were grouped into STDR, non-STDR and no diabetic retinopathy based on ophthalmoscopy. HbA1c level was estimated and its correlation was analysed using SPSS software version 17.0. Association of STDR with duration of diabetes and Body Mass Index (BMI were also studied. RESULTS Out of 250 patients studied, mean age was 58.98 with 126 males and 124 females and there was increased incidence of STDR in males. 104 patients with STDR had HbA1c value of more than 8, high incidence of STDR were noted with increasing levels of HbA1c and the correlation was statistically significant (p = 0.02. 74.1% of patients had STDR in the group with duration of diabetes 11 to 15 years, 90.90% in more than 21 years group compared to 43% in the 5 years group. Increase in duration of diabetes was found to be significantly associated with higher incidence of STDR (p = 0.01. Incidence of STDR were more in patients with normal BMI (p = 0.03. CONCLUSION Poor diabetic control as noted by high HbA1c level and longer duration of diabetes were significantly associated with sightthreatening diabetic retinopathy. Patients with STDR and high HbA1c levels have to be referred for appropriate evaluation and treatment at the earliest to prevent blindness.

d-limonene ameliorates diabetes and its complications in streptozotocin-induced diabetic rats.

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Bacanlı, Merve; Anlar, Hatice Gül; Aydın, Sevtap; Çal, Tuğbagül; Arı, Nuray; Ündeğer Bucurgat, Ülkü; Başaran, A Ahmet; Başaran, Nurşen

2017-12-01

It is known that diabetes causes some complications including alterations in lipid profile, hepatic enzyme levels but also it causes oxidative stress. Limonene, a major component of Citrus oils, has important health beneficial effects in lowering the level of oxidative stress due to its antioxidant activity. The aim of this study was to investigate the effects of D-limonene on streptozotocin (STZ)-induced diabetes in Wistar albino rats. For this purpose, DNA damage was evaluated by alkaline comet assay. Changes in the activities of catalase (CAT), superoxide dismutase (SOD), glutathione reductase (GR) and glutathione peroxidase (GSHPx) and the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), total glutathione (GSH), malondialdehyde (MDA), insulin, total bilirubin and BCA protein, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT), high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol and triglyceride were also evaluated. D-limonene treatment was found to significantly decrease DNA damage, GR enzyme activities and MDA levels and significantly increase GSH levels and CAT, SOD and GSH-Px enzyme activities and altered lipid and liver enzyme parameters in diabetic rats. According to our results, it seems that D-limonene might have a role in the prevention of the complication of diabetes in rats. Copyright © 2017 Elsevier Ltd. All rights reserved.

Longitudinal motivational predictors of dietary self-care and diabetes control in adults with newly diagnosed type 2 diabetes mellitus.

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Nouwen, Arie; Ford, Teri; Balan, Andreea Teodora; Twisk, Jos; Ruggiero, Laurie; White, David

2011-11-01

This prospective study examined relationships between constructs from social-cognitive theory (Bandura, 1986) and self-determination theory (Deci & Ryan, 1985; Deci & Ryan, 1991) and the diabetes outcomes of dietary self-care and diabetes control. Longitudinal data were collected from 237 people newly diagnosed with Type 2 diabetes who filled in questionnaires on dietary self-care, and motivational factors derived from social-cognitive theory and self-determination theory. Blood samples were taken to assess diabetes control (HbA1c). Repeated measurements were taken every 3-4 months for a total of five time points over 18 months. Predictor measures included autonomy support, autonomous and controlled motivation, amotivation, dietary self-efficacy, positive and negative outcome expectancies for dietary self-care and self-evaluation. Age, sex, BMI, and diabetes knowledge were included as control measures. Using Generalized Estimating Equations (GEE) analyses two models were tested: a standard model reflecting longitudinal associations between absolute values of predicted and outcome variables; and a change model examining motivational predictors of changes over time in diabetes outcomes of dietary self-care and diabetes control (HbA1c). Dietary self-care was longitudinally associated with self-efficacy, self-evaluation (the strongest predictor) autonomy support and autonomous motivation, but not with controlled motivation or outcome expectancies. Changes in dietary self-care were predicted by changes in self-efficacy, self-evaluation, and controlled motivation but not by changes in autonomous motivation or autonomy support. Negative outcome expectancies regarding diet were longitudinally associated with HbA1c, and changes in negative outcome expectancies predicted changes in HbA1c. However, there were indications that dietary self-care predicted changes in HbA1c. The results indicate that autonomy support, self-efficacy and, in particular, self-evaluation are key

Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes

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Apostolou Ourania

2009-04-01

Full Text Available Abstract Background A lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D. The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patient's metabolic control and the presence of diabetic complications. Methods A total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately. Results The prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05 and lower LDL-cholesterol levels (115.12 ± 39.76 vs. 127.13 ± 46.53 mg/dl, P = 0.006 than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P 2, P = 0.08, higher prevalence of dyslipidemia (49.8 vs. 44.6%, P = 0.06 and retinopathy (17.9 vs. 14.5%, P = 0.08 compared with patients with no diabetic relatives. No difference in the degree of metabolic control and the prevalence of chronic complications were observed. Conclusion The present study showed an excess maternal transmission of T2D in a sample of Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.

The Prevalance of Diabetes in Psoriatic Patients Versus the Prevalance of Psoriasis in Diabetic Patients

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Nahide Onsun

2010-03-01

Full Text Available Background and Design: Previous studies reported that there are some relations between psoriasis and the diabetes mellitus. However, incidence rates of diabetes mellitus in psoriasis and also incidence rates of psoriasis in diabetes mellitus are lacking.Our aim was to assess and compare incidence rates of diabetes mellitus in patients with psoriasis and incidence rates of psorasis in diabetes mellitus and also evaluate the role of psoriasis as a risk factor for diabetes mellitus. Material and Method: Four hundred eighteen patients with psoriasis and one hundred fifty four patients with diabetes were included. Blood glucose, oral glucose tolerance test (OGTT, glycolised hemoglobine (HbA1C were performed in psoriatic patients and these results were consulted with diabetes clinic. Psoriasis screening by clinical history, dermatologic examination, skin biopsy; if it is necessary were held for patients with diabetes. Results: Prevalance of diabetes was 9.3% in psoriatic patients; prevalance of psoriasis was 1.3% in diabetic patients. The proportion of diabetes was significantly higher in psoriatic patients compared to the proportion of psoriasis in diabetic patients (odds ratio (OR: 7.82, confidence interval (CI: 1.86-32.79, p=0.001. The age and sex-adjusted proportion of diabetes was significantly higher in psoriatic patients as compared the proportion of psoriasis in diabetic patients (OR: 18.35, p<0.001. Differences of mean duration of disease and mean PASİ (psorasis area severity index were not significant between the psoriatic patients without diabetes mellitus and with diabetes mellitus.Conclusion: Risk rate of diabetes is increased in psoriatic patients. Chronic inflammation may lead insulin resistance and diabetes. We think that development of diabetes in patients with psoriasis depends on chronic inflammation. Unfortunately we could not assess the role of therapeutical agents especially effect of potent corticosteroids in development of

Corneal markers of diabetic neuropathy.

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Pritchard, Nicola; Edwards, Katie; Shahidi, Ayda M; Sampson, Geoff P; Russell, Anthony W; Malik, Rayaz A; Efron, Nathan

2011-01-01

Diabetic neuropathy is a significant clinical problem that currently has no effective therapy, and in advanced cases, leads to foot ulceration and lower limb amputation. The accurate detection, characterization and quantification of this condition are important in order to define at-risk patients, anticipate deterioration, monitor progression, and assess new therapies. This review evaluates novel corneal methods of assessing diabetic neuropathy. Two new noninvasive corneal markers have emerged, and in cross-sectional studies have demonstrated their ability to stratify the severity of this disease. Corneal confocal microscopy allows quantification of corneal nerve parameters and noncontact corneal esthesiometry, the functional correlate of corneal structure, assesses the sensitivity of the cornea. Both these techniques are quick to perform, produce little or no discomfort for the patient, and are suitable for clinical settings. Each has advantages and disadvantages over traditional techniques for assessing diabetic neuropathy. Application of these new corneal markers for longitudinal evaluation of diabetic neuropathy has the potential to reduce dependence on more invasive, costly, and time-consuming assessments, such as skin biopsy.

DIABETES AND EXERCISE

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Aydın BALCI

2015-09-01

Full Text Available Diabetes is a crucial health problem due to its incidence and serious complications. Physical inactivity is one of the risk factors associated with it. Therapeutic exercises are beneficial in the treatment and prevention of diabetes. There are several studies about the effects of exercise type and intensity on glycemic control. The exercise programs should be prepared individually after a comprehensive medical evaluation. There are some regulations to prevent acute complications before, after and during the exercises. The importance of regular exercise for public health should be pointed out and physical activity should be urged. The present review discusses issues concerning the prevention and treatment of diabetes through exercise, and the possible risks, in view of current literature.

Alteration of melatonin secretion in patients with type 2 diabetes and proliferative diabetic retinopathy

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Hikichi T

2011-05-01

Full Text Available Taiichi Hikichi1, Naohiro Tateda2, Toshiaki Miura31Department of Ophthalmology, Ohtsuka Eye Hospital, Sapporo; 2Asahikawa National College of Technology, Asahikawa; 3Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, JapanBackground: The purpose of this study was to evaluate the dynamics of plasma melatonin secretion in patients with type 2 diabetes mellitus and diabetic retinopathy.Methods: Plasma melatonin levels were measured by high-performance liquid chromatography in 56 patients. Patients were divided into a diabetic group (30 patients and a nondiabetic group (26 patients. The diabetic group was divided further into a proliferative diabetic retinopathy (PDR group (n = 14 and a nonproliferative diabetic retinopathy (NPDR group (n = 16. Plasma melatonin levels obtained at midnight and 3 am were compared between the groups.Results: Nighttime melatonin levels were significantly lower in the diabetic group than in the nondiabetic group (P < 0.03 and lower in the PDR group than in the nondiabetic and NPDR groups (P < 0.01 and P < 0.03, respectively, but no significant difference was found between the nondiabetic and NPDR groups. The daytime melatonin level did not significantly differ between the nondiabetic and diabetic groups or between the nondiabetic, NPDR, and PDR groups.Conclusion: The nighttime melatonin level is altered in patients with diabetes and PDR but not in diabetic patients without PDR. Although patients with PDR may have various dysfunctions that affect melatonin secretion more severely, advanced dysfunction of retinal light perception may cause altered melatonin secretion. Alteration of melatonin secretion may accelerate further occurrence of complications in diabetic patients.Keywords: circadian rhythm, diabetes, proliferative diabetic retinopathy, melatonin

Furan induced ovarian damage in non-diabetic and diabetic rats and cellular protective role of lycopene.

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Uçar, Semra; Pandir, Dilek

2017-11-01

In our work, furan, lycopene, and furan + lycopene treatments were applied to non-diabetic and diabetic female rats via gavage. Ovarian tissue alterations with histopathology, immunohistochemistry, malondialdehyde levels, oxidative stress parameters such as superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase and harmful effect on ovarian tissue DNA were evaluated in all groups for 28 days. Furan caused the changes histological, ovarian cell's DNA structure, malondialdehyde levels, antioxidant enzymes activities as in a statistically significant manner in each group. Useful effect of lycopene was determined both in non-diabetic and diabetic treatment groups against furan according to the used experimental parameters. Although some histopathological alterations were seen in diabetic and non-diabetic/diabetic plus furan-treated group's ovarians, lycopene restored these variations near to normal levels in furan + lycopene treated groups for in 28 days. Additionally, the results of our immunohistochemical analysis and alterations of the oxidative stress parameters results also supported these findings. Our result confirms that lycopene has protective effect and significantly altered diabetes and furan-induced toxicity in the rat ovarian tissue.

Serum Lipids and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetic Subjects

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Shahana Shermin

2011-07-01

Full Text Available Background: Diabetic retinopathy is the commonest and usually the first observable vascular complication of diabetes mellitus. Along with hyperglycaemia, dyslipidaemia is a contributing factor for the occurrence of diabetic retinopathy. It is postulated that dyslipidaemia results in formation of hard exudate by increasing blood viscosity and altering the fibrinolytic system. A case control study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2006 to December 2007 to evaluate the serum lipid profile in newly diagnosed type 2 diabetic subjects with diabetic retinopathy. Materials and Methods: Total 85 newly diagnosed type 2 diabetic subjects were included in this study, 40 were cases having retinopathy and 45 were age and sex matched controls without retinopathy. Serum triglyceride (TG, total cholesterol (TC, low density lipoprotein cholesterol (LDL-C and high density lipoprotein cholesterol (HDL-C were compared between cases and controls. Unpaired t-test and chi-square test were done between groups as tests of significance. Results: All the parameters of lipid profile showed dyslipidaemic trend both in cases and controls. In the cases TG was significantly higher and HDL-C was significantly lower than that of controls (p < 0.05 whereas no significant difference was found between cases and controls with respect to serum TC and LDL-C. Conclusion: It can be concluded that high TG and low HDL-C are associated with diabetic retinopathy in newly diagnosed type 2 diabetes.

Postpartum development of type 1 diabetes in Asian Indian women with gestational diabetes.

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Unnikrishnan, Ranjit; Shanthi Rani, Coimbatore Subramanian; Anjana, Ranjit Mohan; Uthra, Subash Chandrabose; Vidya, Jaydeep; Sankari, Ganesan Uma; Venkatesan, Ulagamathesan; Rani, Saravanan Jeba; Mohan, Viswanathan

2016-01-01

To study the postpartum conversion of gestational diabetes mellitus (GDM) to different types of diabetes among Asian Indian women. Using data from electronic medical records, 418 women with GDM seen at a tertiary diabetes care center for diabetes in Chennai in South India between 1991 and 2014 were evaluated for development of diabetes postpartum. Of the 418 GDM women followed up postpartum, 388 progressed to diabetes. Of these 359 (92.5%) developed type 2 diabetes (T2DM) and 29 women (7.5%) developed type 1 diabetes (T1DM). The median time to development of T1DM was 2 years (interquartile range 2 [IQR]) while for T2DM it was 5 years (IQR 6). Women who developed T1DM had significantly lower mean body mass index (BMI) (20.4 ± 2.8 vs. 27.5 ± 4.4 kg/m 2 , P = 0.001), and higher fasting plasma glucose (222 ± 105 vs. 165 ± 62 mg/dl P = 0.008) and glycated hemoglobin levels (10.2 ± 2.7 vs. 8.5 ± 2.1% P women who developed T1DM. A small but significant proportion of women with GDM progress to T1DM postpartum. Measurement of GAD antibodies in leaner women with more severe diabetes could help to identify women who are likely to develop T1DM and thus prevent their presentation with acute hyperglycemic emergencies after delivery.

Evaluating the Impact of Diabetes Self-Management Education Methods on Knowledge, Attitudes and Behaviours of Adult Patients With Type 2 Diabetes Mellitus.

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Adam, Laura; O'Connor, Colleen; Garcia, Alicia C

2017-11-23

Diabetes self-management refers to all activities patients undertake to care for their illness, promote health and prevent the long- and short-term effects of diabetes. This study compared the effectiveness of 2 diabetes self-management education methods by examining changes in glycated hemoglobin (A1C) levels and knowledge, attitudes and behaviours (KABs) after traditional group education (TE) or with diabetes conversation maps (CMs). The CMs group was postulated to show greater decrease in A1C levels and improved KABs scores compared to the TE group. A sample of 21 eligible clients from Diabetes Care Guelph were randomly assigned into 2 groups, 10 receiving education through CMs and 11 through TE. Changes in knowledge and attitude were determined by using questionnaires and repeated-measures pretest and post-test design before and after the education sessions. Changes in A1C levels were determined by comparing values at baseline and at 3 months after receiving diabetes education. Two focus groups were conducted to obtain participants' perceptions of the education methods and self-reported KABs changes. Significant differences in knowledge and attitude score changes were observed from baseline/initial education and after 3 months. Both groups had significant decreases in A1C levels from baseline to 3 months afterward. Focus groups revealed themes common to both groups, such as benefits of early education, need for multiple lifestyle behaviour changes and feelings of social support. CMs had significant impact and are effective for group education. The changes observed may lead to improved diabetes self-management, thus reducing costly health complications related to poorly controlled diabetes. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Unexpected cutaneous reactions in diabetic and pre diabetic patients treated with salsalate

International Nuclear Information System (INIS)

Adibi, N.; Faghihimani, E.; Mirbagher, L.; Sohrabi, H.; Toghiani, A.

2012-01-01

Objective: The most commonly reported side effects of salsalate are gastrointestinal events, and few reports are available on its cutaneous side effects. We therefore assessed cutaneous side effects among diabetic/pre-diabetic patients treated with salsalate. Methodology: In a randomized placebo-controlled trial, we evaluated cutaneous side effects in 52 diabetic and 124 pre-diabetic patients, 90 of whom received 3 g/day salsalate and 86 of whom receive a placebo for four weeks. The evaluation was carried out every week using a checklist completed by a single general practitioner. Results: The difference between the salsalate- and placebo-treated groups in overall prevalence of cutaneous reactions was not significant (26.7% versus 17.4%; P < 0.05). Side effects included urticaria (nine (10.1%) salsalate-treated versus six (6.9%) placebo-treated), rashes (five (5.5%) salsalate-treated versus three (3.4%) placebo-treated), pruritus (six (6.7%) salsalate-treated versus three (3.4%) placebo-treated), and edema (two (2.2%) salsalate-treated versus one (1.2%) placebo-treated); in addition, one (1.1%) case of erythema nodosum and one (1.1%) of vasculitis were observed in the salsalate-treated group. In the salsalate group, therapy was discontinued by the physician for three (3.3%) patients because of acute and severe vasculitis, erythema nodosum and urticaria and two (2.2%) patients stopped the treatment themselves because of mild urticaria compared with two patients who stopped using the placebo. Conclusions: Salsalate can cause several and, in some cases, severe cutaneous side effects in patients with diabetes/pre-diabetes. Because these cutaneous eruptions can raise various concerns, including patient non-compliance, greater attention should be paid to dermatological problems in patients under salsalate treatment. (author)

Poor pregnancy outcome in women with type 2 diabetes

DEFF Research Database (Denmark)

Clausen, Tine Dalsgaard; Mathiesen, Elisabeth Reinhardt; Ekbom, Pia

2005-01-01

To evaluate the perinatal outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996-2001.......To evaluate the perinatal outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996-2001....

DETECTION OF MICROVASCULAR CHANGES IN EYES OF PATIENTS WITH DIABETES BUT NOT CLINICAL DIABETIC RETINOPATHY USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

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de Carlo, Talisa E; Chin, Adam T; Bonini Filho, Marco A; Adhi, Mehreen; Branchini, Lauren; Salz, David A; Baumal, Caroline R; Crawford, Courtney; Reichel, Elias; Witkin, Andre J; Duker, Jay S; Waheed, Nadia K

2015-11-01

To evaluate the ability of optical coherence tomography angiography to detect early microvascular changes in eyes of diabetic individuals without clinical retinopathy. Prospective observational study of 61 eyes of 39 patients with diabetes mellitus and 28 control eyes of 22 age-matched healthy subjects that received imaging using optical coherence tomography angiography between August 2014 and March 2015. Eyes with concomitant retinal, optic nerve, and vitreoretinal interface diseases and/or poor-quality images were excluded. Foveal avascular zone size and irregularity, vessel beading and tortuosity, capillary nonperfusion, and microaneurysm were evaluated. Foveal avascular zone size measured 0.348 mm² (0.1085-0.671) in diabetic eyes and 0.288 mm² (0.07-0.434) in control eyes (P = 0.04). Foveal avascular zone remodeling was seen more often in diabetic than control eyes (36% and 11%, respectively; P = 0.01). Capillary nonperfusion was noted in 21% of diabetic eyes and 4% of control eyes (P = 0.03). Microaneurysms and venous beading were noted in less than 10% of both diabetic and control eyes. Both diabetic and healthy control eyes demonstrated tortuous vessels in 21% and 25% of eyes, respectively. Optical coherence tomography angiography was able to image foveal microvascular changes that were not detected by clinical examination in diabetic eyes. Changes to the foveal avascular zone and capillary nonperfusion were more prevalent in diabetic eyes, whereas vessel tortuosity was observed with a similar frequency in normal and diabetic eyes. Optical coherence tomography angiography may be able to detect diabetic eyes at risk of developing retinopathy and to screen for diabetes quickly and noninvasively before the systemic diagnosis is made.

Radionuclide ventriculographic evaluation of exercised left ventricular performance in asymptomatic diabetic patients

International Nuclear Information System (INIS)

Fujii, Yusuke; Hara, Fumio

1991-01-01

Radionuclide ventriculography was made in 49 asymptomatic diabetic patients, aged 30∼70 years, to investigate cardiac function. Comparisons were made with 33 age- and sex-matched non-diabetic controls. Radionuclide ventriculography was performed at rest and during dynamic exercise by multigraded, supine bicycle ergometer. The resting left ventricular ejection fractions were similar between the diabetic patients and control subjects. No significant rise in the left ventricular ejection fractions during dynamic exercise was observed in the diabetic patients [58.4±9.8% (mean±SD) to 60.3±9.9]. In the control subjects, the left ventricular ejection fractions increased during dynamic exercise [59.3±8.4 to 63.0±11.4 (p -1 ) vs -2.66±0.52] and during dynamic exercise [-3.25±0.74 vs -3.23±0.90]. Time to end-systole were similar in both groups at rest [315±42 (ms) vs 309±42] and during dynamic exercise [258±37 vs 262±37]. The resting peak filling rates were similar in both groups [2.27±0.62 (s -1 ) vs 2.45±0.58], and the peak filling rates increased (p 1c in the diabetic patients. These results suggest that diabetic patients have less cardiac reserved performance. (author)

Pattern of cutaneous manifestations in diabetes mellitus

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Goyal Abhishek

2010-01-01

Full Text Available Background: Diabetes mellitus affects individuals of all ages and socioeconomic status. Skin is affected by the acute metabolic derangements as well as by chronic degenerative complications of diabetes. Aims: To evaluate the prevalence of skin manifestations in patients with diabetes mellitus. To analyze the prevalence and pattern of skin disorders among diabetic patients from this region of Western Himalayas. Materials and Methods: One hundred consecutive patients with the diagnosis of diabetes mellitus and having skin lesions, either attending the diabetic clinic or admitted in medical wards were included in this study. Results: The common skin disorders were: x0 erosis (44%, diabetic dermopathy (36%, skin tags (32%, cutaneous infections (31%, and seborrheic keratosis (30%. Conclusion: Skin is involved in diabetes quite often and the manifestations are numerous. High prevalence of xerosis in our diabetic population is perhaps due to cold and dry climatic conditions in the region for most of the time in the year.

Impaired coronary microvascular function in diabetics

International Nuclear Information System (INIS)

Tsujimoto, Go

2000-01-01

Global and regional myocardial uptake was determined with technetium-99m tetrofosmin and a 4 hour exercise (370 MBq iv) and rest (740 MBq iv) protocol, in 24 patients with non-insulin dependent diabetes mellitus and in 22 control subjects. The purpose of this study was to evaluate impaired coronary microvascular function in diabetics by measurement of % uptake increase in myocardial counts. The parameter of % uptake increase (ΔMTU) was calculated as the ratio of exercise counts to rest myocardial counts with correction of myocardial uptake for dose administered and physical decay between the exercise study and the rest study. Global ΔMTU was significantly lower in the diabetics than in control subjects (14.4±5.4% vs. 21.7±8.5%, p<0.01). Regional ΔMTU in each of 4 left ventricular regions (anterior, septal, inferior, posterolateral) was significantly lower in the diabetic group than in the control group (p<0.01) respectively, but there were no significant differences between ΔMTU in the 4 left ventricular regions in the same group. ΔMTU was useful as a non-invasive means of evaluating impaired coronary microvascular function in diabetics. (author)

Evaluating impact of a multi-dimensional education programme on perceived performance of primary care professionals in diabetes care.

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Parekh, Sanjoti; Bush, Robert; Cook, Susan; Grant, Phillipa

2015-11-01

The purpose of this study is to evaluate an educational programme, 'Diabetes Connect: Connecting Professions', which was developed to enhance communication across primary care networks, to support best practice in clinical interventions and progress multidisciplinary team work to benefit patients in diabetes care. A total of 26 workshops were successfully delivered for 309 primary care professionals across the state of Queensland in Australia from November 2011. It consists of two separate, but complementary training elements: a series of online clinical education training modules and state-wide interprofessional learning workshops developed to enhance professional competencies. The evaluation design included completion of online surveys by the participants at two time points: first upon registering for the online modules or workshops; second, one week after attending a workshop. The survey included questions to evaluate the change in role performance measures. Overall, significant increases in participants' current knowledge, perceived ability to adopt this knowledge at work and willingness to change professional behaviour in the short term were observed. The study suggests that for maximum benefit both, workshop and online training, should be combined and made available widely. Future programmes should use a randomised trial design to test the delivery model.

Micronutrients and Diabetic Retinopathy A Systematic Review

NARCIS (Netherlands)

Lee, Chee-Tin Christine; Gayton, Emma L.; Beulens, Joline W. J.; Flanagan, Declan W.; Adler, Amanda I.

Background: We have evaluated the evidence for the association between intake and blood levels of micronutrients and diabetic retinopathy. Treatment for diabetic retinopathy requires significant clinical input and specialist ophthalmologic care. Micronutrients, including vitamin C, vitamin E, and

Lifestyle intervention for type 2 diabetes patients: trial protocol of The Copenhagen Type 2 Diabetes Rehabilitation Project

DEFF Research Database (Denmark)

Vadstrup, Eva S; Frølich, Anne; Perrild, Hans

2009-01-01

BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological t......BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non...... and physical fitness will be examined after 6, 12 and 24 months. DISCUSSION: The Copenhagen Type 2 Diabetes Rehabilitation Project evaluates a multi-disciplinary non-pharmacological intervention programme in a primary care setting and provides important information about how to organize non...... programme consists of empowerment-based education, supervised exercise and dietary intervention. The effectiveness of this multi-disciplinary intervention is compared with conventional individual counselling in a Diabetes Outpatient Clinic and evaluated in a prospective and randomized controlled trial...

Chronic Opium Treatment Can Differentially Induce Brain and Liver Cells Apoptosis in Diabetic and Non-diabetic Male and Female Rats

OpenAIRE

Asiabanha, Majid; Asadikaram, Gholamreza; Rahnema, Amir; Mahmoodi, Mehdi; Hasanshahi, Gholamhosein; Hashemi, Mohammad; Khaksari, Mohammad

2011-01-01

It has been shown that some opium derivatives promote cell death via apoptosis. This study was designed to examine the influence of opium addiction on brain and liver cells apoptosis in male and female diabetic and non-diabetic Wistar rats. This experimental study was performed on normal, opium-addicted, diabetic and diabetic opium-addicted male and female rats. Apoptosis was evaluated by TUNEL and DNA fragmentation assays. Results of this study showed that apoptosis in opium-addicted and dia...

A pragmatic comparison of two diabetes education programs in improving type 2 diabetes mellitus outcomes.

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Dorland, Katherine; Liddy, Clare

2014-03-28

Although it is clear that education programs constitute key elements of improved diabetes management, uncertainty exists regarding the optimal method of delivering that education. In addition to the lack of consensus regarding the most appropriate delivery methods for these programs, there is a paucity of research which evaluates these methods in terms of specific clinical outcomes. This pragmatic study compares the effectiveness of two distinct diabetes education programs in improving clinical outcomes in patients with type 2 diabetes mellitus in a primary care setting. The two diabetes education classes (n = 80 enrolled) retrospectively evaluated were 'the ABC's of Diabetes' (one 2-hour didactic teaching session) and 'Conversation Maps' (3 highly interactive weekly classes, 6 hours in total). Eligible participants (n = 32) had their charts reviewed and outcome measures (i.e., glycosylated hemoglobin levels (HbA1c), low density lipoprotein (LDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), and weight) recorded 1 year prior to and 6 months following the class. Pre- and post-class outcome measures were compared. A trend towards lower HbA1c was observed after completion of both classes, with an average reduction of 0.2%, and 0.6% after 6 months in the 'ABC's of Diabetes' class and 'Conversation Maps' class respectively. A significant decrease in weight was observed 6 months after the 'ABC's of Diabetes' class (p = 0.028), and in LDL after the 'Conversation Maps' class (p = 0.049). Patients with HbA1c ≥ 8% showed a drop of 1.1% in HbA1c 3 months after either class (p = 0.004). No significant difference in outcomes was found between the two diabetes education classes assessed. There was a trend towards improved glycemic control after both classes, and patients with high HbA1c levels demonstrated statistically significant improvements. This indicates that shorter sessions using didactic teaching methods may be equally

Clinicopathological analysis of biopsy-proven diabetic nephropathy based on the Japanese classification of diabetic nephropathy.

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Furuichi, Kengo; Shimizu, Miho; Yuzawa, Yukio; Hara, Akinori; Toyama, Tadashi; Kitamura, Hiroshi; Suzuki, Yoshiki; Sato, Hiroshi; Uesugi, Noriko; Ubara, Yoshifumi; Hohino, Junichi; Hisano, Satoshi; Ueda, Yoshihiko; Nishi, Shinichi; Yokoyama, Hitoshi; Nishino, Tomoya; Kohagura, Kentaro; Ogawa, Daisuke; Mise, Koki; Shibagaki, Yugo; Makino, Hirofumi; Matsuo, Seiichi; Wada, Takashi

2018-06-01

The Japanese classification of diabetic nephropathy reflects the risks of mortality, cardiovascular events and kidney prognosis and is clinically useful. Furthermore, pathological findings of diabetic nephropathy are useful for predicting prognoses. In this study, we evaluated the characteristics of pathological findings in relation to the Japanese classification of diabetic nephropathy and their ability to predict prognosis. The clinical data of 600 biopsy-confirmed diabetic nephropathy patients were collected retrospectively from 13 centers across Japan. Composite kidney events, kidney death, cardiovascular events, all-cause mortality, and decreasing rate of estimated GFR (eGFR) were evaluated based on the Japanese classification of diabetic nephropathy. The median observation period was 70.4 (IQR 20.9-101.0) months. Each stage had specific characteristic pathological findings. Diffuse lesions, interstitial fibrosis and/or tubular atrophy (IFTA), interstitial cell infiltration, arteriolar hyalinosis, and intimal thickening were detected in more than half the cases, even in Stage 1. An analysis of the impacts on outcomes in all data showed that hazard ratios of diffuse lesions, widening of the subendothelial space, exudative lesions, mesangiolysis, IFTA, and interstitial cell infiltration were 2.7, 2.8, 2.7, 2.6, 3.5, and 3.7, respectively. Median declining speed of eGFR in all cases was 5.61 mL/min/1.73 m 2 /year, and the median rate of declining kidney function within 2 years after kidney biopsy was 24.0%. This study indicated that pathological findings could categorize the high-risk group as well as the Japanese classification of diabetic nephropathy. Further study using biopsy specimens is required to clarify the pathogenesis of diabetic kidney disease.

Clinical study of GFR and split renal GFR in evaluating the glomerular function in patients with type 2 diabetes

International Nuclear Information System (INIS)

Fu Hongliang; Li Jinsong; Li Jianing; Wu Jingchuan; Yang Shurong; Gu Zhenhui; Zou Renjian; Shi Haihong

2003-01-01

Objective: To assess glomerular filtration function in patients with type 2 diabetes by glomerular filtration rate (GFR) and split GFR, namely left GFR (LGFR) and right GFR (RGFR). Methods: Fifty-one patients with type 2 diabetes were classified by urine albumin analysis into three groups, normalalbuminuria group (NA), microalbuminuria group(MA) and macroalbuminuria group (MAA) . Twelve patients without diabetes were included into control group. 99 Tc m -DTPA renography was performed on all these cases. GFR and split GFR were calculated by Gates formula. Results: 1) GFR, LGFR and RGFR of NA group were lower than that of the control group. 2) GFR, LGFR and RGFR were significantly correlated with the urine albumin level (r=-0.457, -0.412, -0.424, respectively, P all < 0.01). 3) In all 51 cases, there were 5 cases whose GFR were normal while split GFR were abnormal. Conclusions: 1) GFR and split GFR measurement can detect the incipient damage of glomerular function more sensitively than urine albumin analysis and show the degree of the damage correctly. 2) Split GFR measurement can improve the evaluation of the glomerular function in type 2 diabetes patients

Sistem Multiagen untuk Pengklasteran Pendaki Menggunakan K-Means

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Maya Cendana

2015-01-01

Abstract The beginner climbers should do mountain climbing as a group, however, manually grouping method that is currently running is not effective and efficient , especially for the solo climber who do not have the mountaineering community . Therefore, it is necessary to build an online media that is able to classify mountaineers automatically. The grouping is done by the algorithm K-Means clustering -based intelligent agents . The agents will collaborate in the negotiation process and determines the cluster members that have similar criteria . The main advantage of using multiagentsis multithreading proces, so the clustering process will run at once . The agentsconsists of the user agent , the database agent , clustering agents , and validation agent . The agents are implemented with JADE platform because JADE is using FIPA ACL communication language . Evaluation will calculate the value of cohesion / density in one cluster and inter - cluster separation distances with 10 , 100 and 200 data. Metric measurement used are WGAD and BGAD . Thequality of a cluster member is better than using an usual k-means .   Keywords: agen, jade, fipa acl, wgad, bgad

Usefulness of 123I-Meta-iodobenzylguanidine (MIBG) myocardial scintigraphy for evaluation of cardiac sympathetic nervous system function in diabetic patients

International Nuclear Information System (INIS)

Tamura, Koji; Nakatani, Yuko; Doi, Kenji; Adachi, Gakuji; Takada, Kou; Onishi, Satoshi

2001-01-01

The cardiac sympathetic nervous system function of diabetic patients with no definite cardiovascular complications other than hypertension was evaluated by 123 I -MIBG myocardial scintigraphy. The subjects consisted of 82 diabetic patients, 59 men, 23 women, mean age 57 years, 17 with hypertension and 65 with normal blood pressure, and they were compared with normal controls (8 men and 3 women, mean age 54 years). Myocardial scintigraphy was performed 10 minutes and 4 hours after administration of MIBG. The superior mediastinum and whole myocardium were set as regions of interest, and the heart-to-mediastinum ratio (H/M ratio) and the washout rate (%WR) were calculated. The mean observation period was 18±12 months, and 17 of the 65 diabetic patients with normal blood pressure before the study developed hypertension during the observation period. There were significant differences in H/M ratio and %WR between the diabetic patients and normal controls (H/M ratio; 1.96±0.34 vs 2.27±0.20, %WR; 24.71±16.99% vs 12.89±11.94). The diabetic patients with hypertension had higher morbidity with diabetic retinopathy and a lower H/M ratio. The 17 patients who developed hypertension during the observation period showed an increase in %WR and a reduction in the H/M ratio. Five patients who died during the observation period had a reduced H/M ratio and increased of %WR. 123 I-MIBG myocardial scintigraphy in diabetic patients was shown to be useful for detecting cardiac sympathetic nervous system dysfunction, predicting the development of hypertension, and identifying patients who had a poor outcome. Diabetic patients with abnormal signals on MIBG myocardial scintigraphy need to be monitored much more carefully. (K.H.)

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