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Sample records for stz-treated diabetic group

  1. Quantitative assessment of early experimental diabetes in rats using dynamic contrast-enhanced computed tomography

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    Murase, Kenya [Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: murase@sahs.med.osaka-u.ac.jp; Kitamura, Akihiro; Tachibana, Atsushi; Kusakabe, Yoshinori; Matsuura, Risa; Miyazaki, Shohei [Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita, Osaka 565-0871 (Japan)

    2010-04-15

    Purpose: To quantitatively assess the time course of changes of the renal volume and function in the early phase of streptozotocin (STZ)-induced diabetes in rats using dynamic contrast-enhanced computed tomography (DCE-CT). Methods: The DCE-CT studies were performed in 24 male Sprague-Dawley rats (n = 6 for control and n = 18 for STZ-treated group) on days 0, 4, 7, 11, and 14 using a multi-detector row CT. The rats of an STZ-treated group were given intraperitoneally 65 mg/kg body weight of STZ on day 0, and were divided into two groups based on the blood glucose concentration on day 4 being less than 300 mg/dL [STZ-treated group (L), n = 8] or greater than 300 mg/dL [STZ-treated group (G), n = 10]. The contrast clearance per unit renal volume (K{sub 1}) was estimated from the DCE-CT data using the Patlak model. The renal volume (V{sub CT}) was calculated by manually delineating the kidney on the contrast-enhanced CT image. The contrast clearance of the entire kidney (K) was obtained by K{sub 1} x V{sub CT}. Results: V{sub CT} in the STZ-treated group was significantly enlarged on day 4 compared to that on day 0 and continued until day 14. Although there were no significant changes in the time course of K{sub 1} in all groups, K in the STZ-treated groups (L) and (G) significantly increased on days 7 and 4, respectively, and continued until day 14, suggesting that hyperfiltration occurs in parallel with renal volume enlargement. Conclusion: The present method appears useful for quantitatively evaluating the time course of STZ-induced diabetes in rats, because it allows repeated and simultaneous evaluation of renal morphology and function.

  2. Neurodegenrative changes in retina of rats with streptozotocin diabetes under different conditions of experimental treatment

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    N. V. Kresyun

    2014-08-01

    Full Text Available Introduction. Diabetic retinopathy pathogenesis includes mechanisms of free radical generation and intensification of lipid peroxidation. It was shown that electrical stimulation (ES of cerbellar structures as well as administration of delta-sleep inducing peptide (DSIP is able both to alleviate intensified lipid peroxidation and cause neuroprotective action in neuronal tissue. The aim of research was to investigate the effectiveness of combined usage of DSIP and ES of paleocerebellar cortex upon neurodegenerative manifestations in retina of rats suffered from streptozotocin (STZ- induced diabetes. Methods of investigations. In Wistar rats diabetes have been modeled via i.p. STZ administration (55,0 mg/kg, i.p.. Electrical stimulations (ES (100 Hz, 0,25 ms, 80-120 mcA, 2,5 s of paleocerebellar cortex (V-VII lobules, which have been delivered during ten weeks two times daily (9.00; 19.00, started on 15th day from the moment of STZ injection. DSIP («Sigma-Aldrich Chemie GmbH», Germany have been administered every third day during ten weeks in a dosage of 50 mcg/ kg, i.p. Separate group of STZ-treated rats have been provided with combined usage of DSIP and ES in mentioned dosage and regimen during ten weeks. Retinal hemotoxylin eosin painted slices (5 mcm have been used for light microscopy and calculation of the number of neurons in retinal layers using digital photos. Results have been expressed as number of cells/mm2+SEM. Results. Histological investigation of retina of rats with STZ diabetes revealed the net neurons vacuolization, along with edematic and picnotic deteriorations of neurons. Such disturbances were absent in intact rats and also less pronounced in groups of rats treated with DSIP and paleocerebellar ES. In rats with STZ-induced diabetes the outer nuclear layer contained less number of neurons – by 35,4% when compared with the same index in intact animals (P0,05. The number of neurons in the retinal inner nuclear layer of STZ-treated

  3. Association of insulin resistance with hyperglycemia in streptozotocin-diabetic pigs: effects of metformin at isoenergetic feeding in a type 2-like diabetic pig model

    NARCIS (Netherlands)

    Koopmans, Sietse Jan; Mroz, Zdzislaw; Dekker, Ruud; Corbijn, Henk; Ackermans, Mariette; Sauerwein, Hans

    2006-01-01

    Insulin-mediated glucose metabolism was investigated in streptozotocin (STZ)-treated diabetic pigs to explore if the STZ-diabetic pig can be a suitable model for insulin-resistant, type 2 diabetes mellitus. Pigs (approximately 40 kg) were meal-fed with a low-fat (5%) diet. Hyperinsulinemic (1, 2,

  4. The Antidiabetic Effect of Low Doses of Moringa oleifera Lam. Seeds on Streptozotocin Induced Diabetes and Diabetic Nephropathy in Male Rats

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    Abdulrahman L. Al-Malki

    2015-01-01

    Full Text Available The antidiabetic activity of two low doses of Moringa seed powder (50 and 100 mg/kg body weight, in the diet on streptozotocin (STZ induced diabetes male rats was investigated. Forty rats were divided into four groups. The diabetic positive control (STZ treated group showed increased lipid peroxide, increased IL-6, and decreased antioxidant enzyme in the serum and kidney tissue homogenate compared with that of the negative control group. Immunoglobulins (IgA, IgG, fasting blood sugar, and glycosylated hemoglobin (HbA1c were also increased as a result of diabetes in G2 rats. Moreover albumin was decreased, and liver enzymes and α-amylase were not affected. In addition, the renal functions and potassium and sodium levels in G2 were increased as a sign of diabetic nephropathy. Urine analysis showed also glucosuria and increased potassium, sodium, creatinine, uric acid, and albumin levels. Kidney and pancreas tissues showed also pathological alteration compared to the negative control group. Treating the diabetic rats with 50 or 100 mg Moringa seeds powder/kg body weight in G3 and G4, respectively, ameliorated the levels of all these parameters approaching the negative control values and restored the normal histology of both kidney and pancreas compared with that of the diabetic positive control group.

  5. The antidiabetic effect of low doses of Moringa oleifera Lam. seeds on streptozotocin induced diabetes and diabetic nephropathy in male rats.

    Science.gov (United States)

    Al-Malki, Abdulrahman L; El Rabey, Haddad A

    2015-01-01

    The antidiabetic activity of two low doses of Moringa seed powder (50 and 100 mg/kg body weight, in the diet) on streptozotocin (STZ) induced diabetes male rats was investigated. Forty rats were divided into four groups. The diabetic positive control (STZ treated) group showed increased lipid peroxide, increased IL-6, and decreased antioxidant enzyme in the serum and kidney tissue homogenate compared with that of the negative control group. Immunoglobulins (IgA, IgG), fasting blood sugar, and glycosylated hemoglobin (HbA1c) were also increased as a result of diabetes in G2 rats. Moreover albumin was decreased, and liver enzymes and α-amylase were not affected. In addition, the renal functions and potassium and sodium levels in G2 were increased as a sign of diabetic nephropathy. Urine analysis showed also glucosuria and increased potassium, sodium, creatinine, uric acid, and albumin levels. Kidney and pancreas tissues showed also pathological alteration compared to the negative control group. Treating the diabetic rats with 50 or 100 mg Moringa seeds powder/kg body weight in G3 and G4, respectively, ameliorated the levels of all these parameters approaching the negative control values and restored the normal histology of both kidney and pancreas compared with that of the diabetic positive control group.

  6. The Antidiabetic Effect of Low Doses of Moringa oleifera Lam. Seeds on Streptozotocin Induced Diabetes and Diabetic Nephropathy in Male Rats

    Science.gov (United States)

    Al-Malki, Abdulrahman L.; El Rabey, Haddad A.

    2015-01-01

    The antidiabetic activity of two low doses of Moringa seed powder (50 and 100 mg/kg body weight, in the diet) on streptozotocin (STZ) induced diabetes male rats was investigated. Forty rats were divided into four groups. The diabetic positive control (STZ treated) group showed increased lipid peroxide, increased IL-6, and decreased antioxidant enzyme in the serum and kidney tissue homogenate compared with that of the negative control group. Immunoglobulins (IgA, IgG), fasting blood sugar, and glycosylated hemoglobin (HbA1c) were also increased as a result of diabetes in G2 rats. Moreover albumin was decreased, and liver enzymes and α-amylase were not affected. In addition, the renal functions and potassium and sodium levels in G2 were increased as a sign of diabetic nephropathy. Urine analysis showed also glucosuria and increased potassium, sodium, creatinine, uric acid, and albumin levels. Kidney and pancreas tissues showed also pathological alteration compared to the negative control group. Treating the diabetic rats with 50 or 100 mg Moringa seeds powder/kg body weight in G3 and G4, respectively, ameliorated the levels of all these parameters approaching the negative control values and restored the normal histology of both kidney and pancreas compared with that of the diabetic positive control group. PMID:25629046

  7. Association of ABO blood groups with diabetes mellitus | Kamil ...

    African Journals Online (AJOL)

    Objective: So far no studies have been performed in Malaysia to look at association of diabetes mellitus (DM) with blood groups. We studied the association ... It was found that A and O blood groups were negatively associated with DM type 2 (P<0.05) with higher percentage of A and O groups individuals were non-diabetic.

  8. Comparison of Group B Streptococcal Colonization in the Pregnant Diabetic and Non-Diabetic Women

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    Akhlaghi Farideh

    2009-05-01

    Full Text Available - To Compare colonization of group B streptococcus (GBS in diabetic and non-diabetic pregnant women. In this prospective study 50 pregnant women with diabetes mellitus (both pregestational and gestational and 43 pregnant women without diabetes between 33 and 37 weeks' gestation were evaluated. Three samples for Group B streptococcal culture detection were obtained from each subject in the following order: perinea sample, vaginal sample, and an anorectic sample. All had singleton gestations, negative tests for human immunodeficiency virus, and intact membranes at enrollment. Pearson chi-square and fisher, Exact test were used when appropriate. Most common site of GBS colonization in all women was vagina (11.8%. Colonization of group B streptococcus in control group included vagina (7% perineum (0.3% and rectum 0.3% and in diabetic group included vagina (16% perineum (16% and rectum (16%. Although comparison was shown higher vaginal colonization rate in diabetic group (16% versus 7% but difference was not significant (P=0.154.The prevalence of group B streptococcus colonization in gestational diabetes was 20% and higher than pregestational diabetic women. Among women with pregestational diabetes, the prevalence of group B streptococcus colonization was 15% in non-insulin dependent diabetic women and 10% in insulin dependent diabetic women (P> 0.05. Comparison between two groups showed high rectal colonization in diabetic group and difference was significant (P= 0.027. Pregnant diabetic patients have higher carriage rates of group B streptococcus (GBS in rectum than non-diabetic pregnant women and diabetes is a risk factor for group B streptococcus colonization during pregnancy.

  9. Neuromodulatory Effects of Hesperidin in Mitigating Oxidative Stress in Streptozotocin Induced Diabetes

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    Varshney, Laxmi; Khan, Mohammad Haaris Ajmal; Salman, Mohd.; Naseem, Mehar; Wajid, Saima

    2014-01-01

    Oxidative stress has been implicated in pathogenesis of streptozotocin- (STZ-) induced diabetes mellitus and its complication in central nervous system (CNS). Recent studies have provided insights on antioxidants and their emergence as potential therapeutic and nutraceutical. The present study examined the hypothesis that hesperidin (HP) ameliorates oxidative stress and may be a limiting factor in the extent of CNS complication following diabetes. To test this hypothesis rats were divided into four groups: control, diabetic, diabetic-HP treated, and vehicle for HP treatment group. Diabetes mellitus was induced by a single injection of STZ (65 mg/kg body weight). Three days after STZ injection, HP was given (50 mg/kg b.wt. orally) once daily for four weeks. The results of the present investigation suggest that the significant elevated levels of oxidative stress markers were observed in STZ-treated animals, whereas significant depletion in the activity of nonenzymatic antioxidants and enzymatic antioxidants was witnessed in diabetic rat brain. Neurotoxicity biomarker activity was also altered significantly. HP treatment significantly attenuated the altered levels of oxidative stress and neurotoxicity biomarkers. Our results demonstrate that HP exhibits potent antioxidant and neuroprotective effects on the brain tissue against the diabetic oxidative damage in STZ-induced rodent model. PMID:25050332

  10. Neuromodulatory Effects of Hesperidin in Mitigating Oxidative Stress in Streptozotocin Induced Diabetes

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    Mohammad Ashafaq

    2014-01-01

    Full Text Available Oxidative stress has been implicated in pathogenesis of streptozotocin- (STZ- induced diabetes mellitus and its complication in central nervous system (CNS. Recent studies have provided insights on antioxidants and their emergence as potential therapeutic and nutraceutical. The present study examined the hypothesis that hesperidin (HP ameliorates oxidative stress and may be a limiting factor in the extent of CNS complication following diabetes. To test this hypothesis rats were divided into four groups: control, diabetic, diabetic-HP treated, and vehicle for HP treatment group. Diabetes mellitus was induced by a single injection of STZ (65 mg/kg body weight. Three days after STZ injection, HP was given (50 mg/kg b.wt. orally once daily for four weeks. The results of the present investigation suggest that the significant elevated levels of oxidative stress markers were observed in STZ-treated animals, whereas significant depletion in the activity of nonenzymatic antioxidants and enzymatic antioxidants was witnessed in diabetic rat brain. Neurotoxicity biomarker activity was also altered significantly. HP treatment significantly attenuated the altered levels of oxidative stress and neurotoxicity biomarkers. Our results demonstrate that HP exhibits potent antioxidant and neuroprotective effects on the brain tissue against the diabetic oxidative damage in STZ-induced rodent model.

  11. [Type 2 diabetes mellitus in the pediatric age group].

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    Amaya, María J; Colino, E; López-Capapé, M; Alonso, M; Barrio, R

    2005-02-01

    In the past two decades, type 2 diabetes mellitus has increased in children and adolescents, especially within certain ethnic groups. This increase has been parallel to the rising prevalence of obesity. Because of the overlap between some clinical characteristics, the differential diagnosis between type 1 and 2 diabetes is difficult. Of 300 diabetic patients in our diabetes section, only three (1 %) had type 2 diabetes. Two patients were obese adolescents with a positive family history of type 2 diabetes mellitus; the third patient was a prepubertal, overweight girl with no family history of this disorder. The diagnosis was incidental in two patients and one patient presented with ketoacidosis. The differences between the three patients reveal the great clinical variability of this disorder and suggest that various underlying factors are involved in the pathophysiology of type 2 diabetes.

  12. Employee perceptions of diabetes education needs: a focus group study.

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    Wood, Felecia; Jacobson, Sharol

    2005-10-01

    The purpose of this descriptive non-experimental research was to assess employee perceptions of desired diabetes education through focus groups. Thirteen employees of a southern university in three focus groups identified many standard and some emerging educational topics of interest including healthier food choices when eating out, increasing activity, deciding whether highly advertised "special" products for diabetes were necessary, and recognizing the importance of obesity among children. The employees were willing to attend group meetings related to diabetes, but not to pay for them. The information will be used to plan an intervention to promote diabetes prevention and self-management in a worksite environment where diabetes costs are rising rapidly, and to support the need for a university wellness program. Occupational health nurses can address both employees' needs and employers' costs through such a program.

  13. Educational Strategies of Diabetes Group Medical Visits: A Review.

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    Kirk, Julienne K; Devoid, Hannah Marie; Strickland, Carmen

    2017-02-03

    Diabetes is a demanding disease that is growing in prevalence. Improved outcomes for patients with diabetes are highly dependent on self-management skills and the ability to make lifestyle changes. Innovative healthcare approaches are necessary to meet these specific patient needs. A group care medical visit (GMV) combines diabetes check-ups with diabetes education in a supportive and patient centered environment that promotes effective self-management. GMVs are associated with improved diabetes outcomes including hemoglobin A1C, weight, and self-efficacy; however details of the methods by which content is delivered to achieve these outcomes remain vague. Improved GMV diabetes outcomes may be the result of specific processes used in group care models. We seek to describe educational strategies, content, and qualities of facilitators that contribute to successful outcomes associated with diabetes GMVs . A review of the literature was conducted focusing on GMVs, specifically the educational strategies implemented, topics discussed, and facilitator qualities that contribute to successful outcomes. We identified 260 studies containing information about GMVs in patients with diabetes. A total of 7 citations met inclusion criteria and additional 5 were found through reference lists and relevant papers. Diabetes GMV educational topics comprise standard themes of disease process, medication, nutrition, and exercise. Several programs, however, target the development and realization of individualized patient goals, giving the patient more involvement in the session. Methods for facilitation may hold the key to successfully activating patients to reach meaningful behavior change goals. In addition to using expert clinical skills in diabetes care, effective facilitators provide support, and empower patients to take ownership of their diabetes. Rigorous evaluation of best practices for both the type and methods of delivering content in GMVs is lacking. Translational research to

  14. Initial Assessment of β3-Adrenoceptor-Activated Brown Adipose Tissue in Streptozotocin-Induced Type 1 Diabetes Rodent Model Using [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

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    Aparna Baranwal

    2015-12-01

    Full Text Available Metabolic activity of brown adipose tissue (BAT is activated by β3-adrenoceptor agonists and norepinephrine transporter (NET blockers and is measurable using [18F]fluorodeoxyglucose ([18F]FDG positron emission tomography/computed tomography (PET/CT in rats. Using the streptozotocin (STZ-treated rat model of type 1 diabetes mellitus (T1DM, we investigated BAT activity in this rat model under fasting and nonfasting conditions using [18F]FDG PET/CT. Drugs that enhance BAT activity may have a potential for therapeutic development in lowering blood sugar in insulin-resistant diabetes. Rats were rendered diabetic by administration of STZand confirmed by glucose measures. [18F]FDG was injected in the rats (fasted or nonfasted pretreated with either saline or β3-adrenoceptor agonist CL316,243 or the NET blocker atomoxetine for PET/CT scans. [18F]FDG metabolic activity was computed as standard uptake values (SUVs in interscapular brown adipose tissue (IBAT and compared across the different drug treatment conditions. Blood glucose levels > 500 mg/dL were established for the STZ-treated diabetic rats. Under fasting conditions, average uptake of [18F]FDG in the IBAT of STZ-treated diabetic rats was approximately 70% lower compared to that of normal rats. Both CL316,243 and atomoxetine activated IBAT in normal rats had an SUV > 5, whereas activation in STZ-treated rats was significantly lower. The agonist CL316,243 activated IBAT up to threefold compared to saline in the fasted STZ-treated rat. In the nonfasted rat, the IBAT activation was up by twofold by CL316243. Atomoxetine had a greater effect on lowering blood sugar levels compared to CL316,243 in the nonfasted rats. A significant reduction in metabolic activity was observed in the STZ-treated diabetic rodent model. Increased IBAT activity in the STZ-treated diabetic rat under nonfasted conditions using the β3-adrenoceptor agonist CL316,243 suggests a potential role of BAT in modulating blood sugar

  15. Patient involvement in diabetes care: experiences in nine diabetes care groups.

    NARCIS (Netherlands)

    Lemmens, L.C.; Bruin, S.R. de; Struijs, J.N.; Rijken, M.; Nijpels, G.; Baan, C.A.

    2015-01-01

    Introduction: Despite the expected beneficial effects on quality of care, patient involvement in diabetes care groups, which deliver a bundled paid integrated care programme for diabetes type 2, seems to be limited. The aim of this study was to gain insight into levels and methods of patient

  16. [Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group].

    Science.gov (United States)

    García-Humbría, Leila; Richard-Yegres, Nicole; Pérez-Blanco, Maigualida; Yegres, Francisco; Mendoza, Mireya; Acosta, Arnaldo; Hernández, Rosaura; Zárraga, Eluz

    2005-03-01

    Superficial mycoses are considered to affect more frequently patients with type 2 diabetes mellitus (DM-2), specially onychomycosis and Tinea pedis. The purpose of this study was to compare the dermatophytoses, candidiasis and Pitiriasis versicolor frequency between 40 patients with DM-2 and 40 healthy persons of either sex, 40 years old or more. Clinical, metabolic, mycologic and inmunologic studies against Candida albicans, were carried out. Both diabetics 75% (30/40) and controls 65% (26/40) presented a high frequency of superficial mycoses (no significant difference p = 0.329). Pitiriasis versicolor was not detected in diabetic patients. They presented Tinea unguium, concomitant with Tinea pedis, with a higher frequency. The predominant dermatophyte was Trichophyton rubrum 18/23 (78%) in diabetics and 8/16 (50%) in non diabetics. Candida was isolated as commensal from oral mucous: 23/40 (58%) in diabetics and 21/40 (52%) in non diabetics (serotipo A was the more frequent), and from onychomycosis: 11/40 (28%) in diabetics and 12/40 (30%) in non diabetics. The immunological response was the same in both groups: celular 100%, humoral 20%. No statistical correlation among superficial mycoses, blood glucose level, glycosylated hemoglobin values or the time suffering the disease was observed. The high susceptibility to dermatophytes and Candida sp. infection showed to be associated with age and no with the diabetic type 2 condition in those patients.

  17. The distribution of the ABO blood groups among the diabetes ...

    African Journals Online (AJOL)

    2014-02-12

    Feb 12, 2014 ... healthy adults above 18 years of age were recruited from the blood bank and 1650 individuals agreed to take part in this study, giving a ..... Table 3: Global comparison of distribution of ABO blood groups among diabetic population. Country. Total sample size. ABO blood groups (%). Year. A. B. AB. 0.

  18. Views of patients on a group diabetes education programme using ...

    African Journals Online (AJOL)

    Objectives: This study was a qualitative assessment of a diabetes group education programme presented in community health centres of the Cape Town Metro District. The programme offered four sessions of group education and was delivered by trained health promoters using a guiding style derived from motivational ...

  19. Association of ABO blood groups with diabetes mellitus

    African Journals Online (AJOL)

    2010-02-08

    Feb 8, 2010 ... Objective: So far no studies have been performed in Malaysia to look at association of diabetes mellitus (DM) with blood groups. We studied the association of ABO blood groups with DM type 2. Patients and methodology: It was a case control study conducted at Kepala Batas Hospital Batas, Penang,.

  20. The distribution of the ABO blood groups among the diabetes ...

    African Journals Online (AJOL)

    Background: There is strong evidence in the literature that there is an association between ABO blood group and certain diseases. Aim: The aim of this study was to investigate any association between the ABO blood groups and diabetes mellitus (DM) in Qatar. Design: This was a sex.matched case.control study.

  1. Effects of Caffeine and Lycopene in Experimentally Induced Diabetes Mellitus.

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    Ozmen, Ozlem; Topsakal, Senay; Haligur, Mehmet; Aydogan, Ahmet; Dincoglu, Dilnur

    2016-04-01

    Diabetes mellitus (DM) is a global epidemic with increasing prevalence. The disease is chronic in nature, and patients must use antidiabetic drugs or insulin during their lifespan. Because of the difficulty of using injectable insulin preparations, patients and practitioners prefer to use oral antidiabetic drugs for prophylaxis and treatment. There are, however, numerous adverse effects of antidiabetic drugs and rapidly increasing attention is being paid to new nutraceutical drugs with fewer adverse effects. The purpose of this study was to evaluate the effects of caffeine and lycopene on streptozotocin (STZ)-induced DM in rats. Caffeine and lycopene were administered to the study groups by oral gavages for 1 month whereafter experimental diabetes was induced in 90 rats in 6 groups. There were no pathological effects of lycopene and caffeine on the pancreas. Marked vacuolization and degeneration were observed in STZ-treated groups. Caffeine and lycopene decreased the pathological findings and lowered the blood and urine glucose levels in the rats with STZ-induced DM, whereas these compounds increased serum insulin levels. This study showed that caffeine and lycopene provided protective effects against experimentally induced DM. The protective effects of lycopene were observed to be much greater than those of caffeine.

  2. Diabetes quality management in care groups and outpatient clinics

    NARCIS (Netherlands)

    Campmans-Kuijpers, M.J.E.

    2015-01-01

    This research project relates to diabetes quality management in Dutch care groups (40-200 GP practices) and outpatient clinics. Improvement of quality management at an organisational level on top of the existing quality management in separate general practices is expected to be associated with

  3. [A self-care group in diabetes mellitus type 2].

    Science.gov (United States)

    Díaz-Nieto, L; Galán-Cuevas, S; Fernández-Pardo, G

    1993-01-01

    The present work presents the experience of a diabetes self-care group in San Antonio Tecomitl, Milpa Alta, D.F., México. Diabetes is a serious disease posing a public health problem in our country, since it affects a great number of productive age persons, causing, if uncontrolled, deleterious effects on their life quality and expectancy because of vascular and neural complications. We carried out an intervention in six female patients diagnosed as having diabetes mellitus type II, with different stages of the disease; all of them were residents of Milpa Alta municipality, with an average age of 63.6 years. They were receiving different doses of oral hypoglycemic agents. The group of patients met once a week for two-hour sessions in which they received: a) information about diabetes mellitus, b) self-care training and c) profound relaxation techniques. In each session we evaluated glycemia, body weight and blood pressure in each patient. Results from the intervention showed no correlation between body weight and blood pressure, though there was a significant variation in glycemia levels after the intervention.

  4. Patient involvement in diabetes care: experiences in nine diabetes care groups

    Directory of Open Access Journals (Sweden)

    Lidwien Lemmens

    2015-12-01

    Full Text Available Introduction: Despite the expected beneficial effects on quality of care, patient involvement in diabetes care groups, which deliver a bundled paid integrated care programme for diabetes type 2, seems to be limited. The aim of this study was to gain insight into levels and methods of patient involvement, into facilitators and barriers, and into the future preferences of care groups and patient representatives.Theory and methods: Semi-structured interviews were held with 10 representatives of care groups and 11 representatives of patient advocacy groups. An adapted version of Arnstein's ladder of citizen participation was used to define five levels of patient involvement.Results: Patient involvement in care groups was mostly limited to informing and consulting patients. Higher levels, i.e., advising, co-producing and decision-making, were less frequently observed. Care groups and patient representatives perceived largely the same barriers and facilitators and had similar preferences regarding future themes and design of patient involvement.Conclusion: Constructive collaboration between diabetes care groups and patient representatives to enhance patient involvement in the future seems viable. Several issues such as the lack of evidence for effectiveness of patient involvement, differences in viewpoints on the role and responsibilities of care groups and perceived barriers need to be addressed.

  5. The impact of diabetic retinopathy: perspectives from patient focus groups.

    Science.gov (United States)

    Coyne, Karin S; Margolis, Mary Kay; Kennedy-Martin, Tessa; Baker, Timothy M; Klein, Ronald; Paul, Matthew D; Revicki, Dennis A

    2004-08-01

    Diabetic retinopathy (DR) affects 50-85% of people with diabetes and may result in visual impairment or blindness. This exploratory qualitative research was conducted to evaluate the symptom experience of DR, its impact on daily activities and health-related quality of life (HRQL), and the applicability of two vision-specific questionnaires. Four focus groups (n = 15) were conducted with people with DR to explore their symptom experience and the impact on functioning and HRQL. Adults with type I or II diabetes and mild, moderate or severe non-proliferative DR (NPDR) or proliferative DR (PDR) were recruited. Content analysis and descriptive statistics were used to analyse the data. Participants described a range of symptoms and impact. Difficulty driving, especially at night, and trouble reading were noted with all levels of severity. Participants with PDR and decreased visual acuity have foregone many other important life aspects such as work, reading and sports. For the severely affected, diabetic care activities (e.g. exercising, reading nutritional labels, preparing insulin injections and glucose testing) were difficult to accomplish. Loss of independence, especially mobility and increased fear of accidents, had a profound impact on social activities. For those patients who had not experienced other complications of diabetes, the threat of vision loss was the most devastating. The loss of independence and mobility associated with decreased visual functioning and visual loss were major concerns. Moderate, severe NPDR and PDR associated with visual impairment have a significant impact on HRQL, particularly in the areas of independence, mobility, leisure and self-care activities.

  6. Candesartan restores pressure-induced vasodilation and prevents skin pressure ulcer formation in diabetic mice.

    Science.gov (United States)

    Danigo, Aurore; Nasser, Mohamad; Bessaguet, Flavien; Javellaud, James; Oudart, Nicole; Achard, Jean-Michel; Demiot, Claire

    2015-02-18

    Angiotensin II type 1 receptor (AT1R) blockers have beneficial effects on neurovascular complications in diabetes and in organ's protection against ischemic episodes. The present study examines whether the AT1R blocker candesartan (1) has a beneficial effect on diabetes-induced alteration of pressure-induced vasodilation (PIV, a cutaneous physiological neurovascular mechanism which could delay the occurrence of tissue ischemia), and (2) could be protective against skin pressure ulcer formation. Male Swiss mice aged 5-6 weeks were randomly assigned to four experimental groups. In two groups, diabetes was induced by a single intraperitoneal injection of streptozotocin (STZ, 200 mg.kg(-1)). After 6 weeks, control and STZ mice received either no treatment or candesartan (1 mg/kg-daily in drinking water) during 2 weeks. At the end of treatment (8 weeks of diabetes duration), C-fiber mediated nociception threshold, endothelium-dependent vasodilation and PIV were assessed. Pressure ulcers (PUs) were then induced by pinching the dorsal skin between two magnetic plates for three hours. Skin ulcer area development was assessed during three days, and histological examination of the depth of the skin lesion was performed at day three. After 8 weeks of diabetes, the skin neurovascular functions (C-fiber nociception, endothelium-dependent vasodilation and PIV) were markedly altered in STZ-treated mice, but were fully restored by treatment with candesartan. Whereas in diabetes mice exposure of the skin to pressure induced wide and deep necrotic lesions, treatment with candersartan restored their ability to resist to pressure-induced ulceration as efficiently as the control mice. Candesartan decreases the vulnerability to pressure-induced ulceration and restores skin neurovascular functions in mice with STZ-induced established diabetes.

  7. Integrating education, group support, and case management for diabetic Hispanics.

    Science.gov (United States)

    Brown, Sharon A; García, Alexandra A; Winter, Mary; Silva, Lita; Brown, Adama; Hanis, Craig L

    2011-01-01

    Culturally tailored diabetes self-management education (DSME) improves glycemic control and other health outcomes in Mexican Americans but sociocultural barriers to health improvements remain. This study explored the feasibility of adding a nurse case manager (NCM) to DSME to foster DSME attendance and increase utilization of other available health care services. The setting was a rural community on the Texas-Mexico border in one of the poorest counties in the United States. Using a repeated measures pretest, post-test control group design, we enrolled 165 Mexican American adults into: 1) an experimental group that received a DSME intervention plus access to a NCM; or 2) a control group that received DSME only. Both experimental and control groups received the DSME intervention, reported positive changes in diet and physical activity, and showed improved clinical outcomes; there were no significant group differences. A statistically significant reduction in body mass index was seen in women compared to men, regardless of group or number of NCM contacts. For individuals having the most NCM contacts, DSME attendance rates were greater. Participants expressed acceptance of the NCM; they preferred face-to-face contact rather than by telephone. Our previously tested, culturally tailored DSME continues to be an effective strategy for improving glycemic control in Mexican Americans. This feasibility study provided partial support for the NCM model for underserved border communities, but additional research is needed on resource utilization and the nature of NCM contacts.

  8. Chrysin, an anti-inflammatory molecule, abrogates renal dysfunction in type 2 diabetic rats

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    Ahad, Amjid [Lipid Metabolism Laboratory, Department of Biochemistry, Faculty of Science, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India); Ganai, Ajaz Ahmad [Department of Biotechnology, Faculty of Science, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India); Mujeeb, Mohd [Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India); Siddiqui, Waseem Ahmad, E-mail: was.sid121@gmail.com [Lipid Metabolism Laboratory, Department of Biochemistry, Faculty of Science, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India)

    2014-08-15

    Diabetic nepropathy (DN) is considered as the leading cause of end-stage renal disease (ESRD) worldwide, but the current available treatments are limited. Recent experimental evidences support the role of chronic microinflammation in the development of DN. Therefore, the tumor necrosis factor-alpha (TNF-α) pathway has emerged as a new therapeutic target for the treatment of DN. We investigated the nephroprotective effects of chrysin (5, 7-dihydroxyflavone) in a high fat diet/streptozotocin (HFD/STZ)-induced type 2 diabetic Wistar albino rat model. Chrysin is a potent anti-inflammatory compound that is abundantly found in plant extracts, honey and bee propolis. The treatment with chrysin for 16 weeks post induction of diabetes significantly abrogated renal dysfunction and oxidative stress. Chrysin treatment considerably reduced renal TNF-α expression and inhibited the nuclear transcription factor-kappa B (NF-kB) activation. Furthermore, chrysin treatment improved renal pathology and suppressed transforming growth factor-beta (TGF-β), fibronectin and collagen-IV protein expressions in renal tissues. Chrysin also significantly reduced the serum levels of pro-inflammatory cytokines, interleukin-1beta (IL-1β) and IL-6. Moreover, there were no appreciable differences in fasting blood glucose and serum insulin levels between the chrysin treated groups compared to the HFD/STZ-treated group. Hence, our results suggest that chrysin prevents the development of DN in HFD/STZ-induced type 2 diabetic rats through anti-inflammatory effects in the kidney by specifically targeting the TNF-α pathway. - Highlights: • Chrysin reduced renal oxidative stress and inflammation in diabetic rats. • Chrysin reduced serum levels of pro-inflammatory in diabetic rats. • Chrysin exhibited renal protective effect by suppressing the TNF-α pathway.

  9. Diabetes self-care behaviors and disease control in support group attenders and nonattenders.

    Science.gov (United States)

    Chiou, Chii-Jun

    2014-12-01

    The prevalence rate and mortality rate of diabetes continue to increase annually. Complications associated with poor control of diabetes include renal dialysis, amputation, heart disease, stroke, retinopathy, and vascular disease, all of which have an impact at the individual, family, and national level. This study compares diabetes self-care behavior and disease control efficacy between attenders and nonattenders of a diabetes support group. We used a questionnaire with good validity and reliability to conduct a cross-sectional survey. Diabetes support groups have been established throughout Taiwan for around 2 years. Participants for this study were recruited randomly from a register of support group participants. Support group instructors were asked to collect questionnaires from those attending and not attending their support groups. Ten groups volunteered to participate in this study. We received 147 valid questionnaires from participants attending support groups (attenders) and 93 questionnaires from participants who did not (nonattenders). There were no statistically significant differences between support group attenders and nonattenders in terms of age, educational level, or time since diagnosis of diabetes. Thus, we assumed these two groups as adequately similar to conduct statistical comparisons. Scores for diabetes self-care behavior, disease control, and use of the diabetes passport were all significantly higher among support group attenders than their nonattender peers. Results indicate that people attending diabetes support groups are more likely to have better self-care behavior and disease control than nonattenders. Therefore, we suggest that the government actively promote policies supportive of diabetes support groups.

  10. Impact of the International Association of Diabetes and Pregnancy Study Groups criteria for gestational diabetes.

    Science.gov (United States)

    Trujillo, Janet; Vigo, Alvaro; Duncan, Bruce B; Falavigna, Maicon; Wendland, Eliana M; Campos, Maria A; Schmidt, Maria I

    2015-05-01

    To evaluate the diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and alternative criteria in terms of resultant prevalence of gestational diabetes mellitus (GDM) and measures of diagnostic impact. The Brazilian Gestational Diabetes Study (EBDG) is a cohort of pregnant women enrolled consecutively in prenatal care clinics of the Brazilian National Health Service from 1991 to 1995, a time and setting in which those with lesser than diabetes hyperglycemia rarely received drug treatment. Eligibility criteria were age ≥20 years, gestational age 20-28 weeks and no history of diabetes outside pregnancy. After interview and anthropometric measurements, a standardized 2h 75g OGTT was scheduled. Women were followed through early postpartum. Prevalence of GDM defined by IADPSG criteria was 18.0% (95% CI 16.9-19.0), ranging from 2.7 to 17.0% with the alternative criteria. Relative risks for large for gestational age (LGA) and preeclampsia were generally small. The diagnostic impact assessed by pre- to post-test gain in the probability of an outcome was also small (3.6% for LGA and 0.5% for preeclampsia). Alternative criteria reached maximum gains of 9.7% and 5.3%, respectively. The fractions of LGA births and preeclampsia attributable to GDM by the IADPSG criteria were small, 6.7% and 3.5%, respectively. The IADPSG criteria identify more women as having GDM but their diagnostic and population impacts with respect to adverse outcomes are small. Alternative definitions, although also presenting small diagnostic and population impacts, showed advantages which may be useful in specific settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. The role of blood groups in the development of diabetes mellitus after gestational diabetes mellitus

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    Karagoz H

    2015-10-01

    Full Text Available Hatice Karagoz,1 Abdulsamet Erden,2 Ozerhan Ozer,2 Kubra Esmeray,2 Ali Cetinkaya,2 Deniz Avci,2 Samet Karahan,2 Mustafa Basak,2 Kadir Bulut,2 Hasan Mutlu,3 Yasin Simsek4 1Internal Medicine Department, Acibadem Kayseri Hospital, 2Internal Medicine Department, 3Medical Oncology Department, 4Endocrinology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Introduction: Gestational diabetes mellitus (GDM is a common condition that is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy and it affects approximately 5% of all pregnancies all over the world. GDM is not only associated with adverse pregnancy outcomes such as macrosomia, dystocia, birth trauma, and metabolic complications in newborns, but it is also a strong predictor of transitioning to overt DM postpartum. The association of ABO blood groups with DM has been observed before in several epidemiological and genetic studies and resulted with inconsistent findings, but still there are not enough studies in the literature about the association of ABO blood groups with GDM. In this study, we aimed at investigating any possible relationship between the ABO blood group system and GDM and also the transitioning of GDM to overt DM postpartum, in Turkey.Patients and methods: A total of 233 patients with GDM from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. The cases that have serologically determined blood groups and Rh factor in the hospital records were included in the study, and the patients with unknown blood groups were excluded. Patients were classified according to blood groups (A, B, AB, and O and Rh status (+/-. GDM was diagnosed based on the glucose cut-points of the International Association of the Diabetes and Pregnancy Society Groups. The distributions of blood groups of the patients with GDM were compared with the distribution of blood groups of 17,314 healthy donors who were

  12. Effects of High Fat Feeding and Diabetes on Regression of Atherosclerosis Induced by Low-Density Lipoprotein Receptor Gene Therapy in LDL Receptor-Deficient Mice.

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    Florian Willecke

    Full Text Available We tested whether a high fat diet (HFD containing the inflammatory dietary fatty acid palmitate or insulin deficient diabetes altered the remodeling of atherosclerotic plaques in LDL receptor knockout (Ldlr-/- mice. Cholesterol reduction was achieved by using a helper-dependent adenovirus (HDAd carrying the gene for the low-density lipoprotein receptor (Ldlr; HDAd-LDLR. After injection of the HDAd-LDLR, mice consuming either HFD, which led to insulin resistance but not hyperglycemia, or low fat diet (LFD, showed regression compared to baseline. However there was no difference between the two groups in terms of atherosclerotic lesion size, or CD68+ cell and lipid content. Because of the lack of effects of these two diets, we then tested whether viral-mediated cholesterol reduction would lead to defective regression in mice with greater hyperglycemia. In both normoglycemic and streptozotocin (STZ-treated hyperglycemic mice, HDAd-LDLR significantly reduced plasma cholesterol levels, decreased atherosclerotic lesion size, reduced macrophage area and lipid content, and increased collagen content of plaque in the aortic sinus. However, reductions in anti-inflammatory and ER stress-related genes were less pronounced in STZ-diabetic mice compared to non-diabetic mice. In conclusion, HDAd-mediated Ldlr gene therapy is an effective and simple method to induce atherosclerosis regression in Ldlr-/- mice in different metabolic states.

  13. Obestatin induced recovery of myocardial dysfunction in type 1 diabetic rats: underlying mechanisms

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    Aragno Manuela

    2012-10-01

    Full Text Available Abstract Background The aim of this study was to investigate whether obestatin (OB, a peptide mediator encoded by the ghrelin gene exerting a protective effect in ischemic reperfused heart, is able to reduce cardiac dysfunctions in adult diabetic rats. Methods Diabetes was induced by STZ injection (50 mg/kg in Wistar rats (DM. OB was administered (25 μg/kg twice a day for 6 weeks. Non-diabetic (ND rats and DM rats were distributed into four groups: untreated ND, OB-treated ND, untreated DM, OB-treated DM. Cardiac contractility and ß-adrenergic response were studied on isolated papillary muscles. Phosphorylation of AMPK, Akt, ERK1/2 and GSK3ß as well ß-1 adrenoreceptors levels were detected by western blot, while α-MHC was measured by RT-PCR. Results OB preserved papillary muscle contractility (85 vs 27% of ND, ß-adrenergic response (103 vs 65% of ND, as well ß1-adrenoreceptors and α-MHC levels in diabetic myocardial tissue. Moreover, OB up-regulated the survival kinases Akt and ERK1/2, and enhanced AMPK and GSK3ß phosphorylation. OB corrected oxidative unbalance, reduced pro-inflammatory cytokine TNF-α plasma levels, NFkB translocation and pro-fibrogenic factors expression in diabetic myocardium. Conclusions OB displays a significant beneficial effect against the alterations of contractility and ß-adrenergic response in the heart of STZ-treated diabetic rats, which was mainly associated with the ability of OB to up-regulate the transcription of ß1-adrenergic receptors and α-MHC; this protective effect was accompanied by the ability to restore oxidative balance and to promote phosphorylation/modulation of AMPK and pro-survival kinases such as Akt, ERK1/2 and GSK3ß.

  14. Gestational diabetes mellitus: Challenges for different ethnic groups

    Science.gov (United States)

    Yuen, Lili; Wong, Vincent W

    2015-01-01

    Ethnicity is defined as “belonging to a social group that has a common national or cultural tradition”. Membership of certain ethnic groups has long been associated with increased risk of gestational diabetes mellitus (GDM). Studies that examined ethnic differences amongst women with GDM were often conducted in western countries where women from various ethnic backgrounds were represented. The prevalence of GDM appears to be particularly high among women from South Asia and South East Asia, compared to Caucasian, African-American and Hispanic communities. For some, but not all ethnic groups, the body mass index is a risk factor for the development of GDM. Even within a particular ethnic group, those who were born in their native countries have a different risk profile for GDM compared to those born in western countries. In terms of treatment, medical nutrition therapy (MNT) plays a key role in the management of GDM and the prescription of MNT should be culturally sensitive. Limited studies have shown that women who live in an English-speaking country but predominantly speak a language other than English, have lower rates of dietary understanding compared with their English speaking counterparts, and this may affect compliance to therapy. Insulin therapy also plays an important role and there appears to be variation as to the progression of women who progress to requiring insulin among different ethnicities. As for peri-natal outcomes, women from Pacific Islander countries have higher rates of macrosomia, while women from Chinese backgrounds had lower adverse pregnancy outcomes. From a maternal outcome point of view, pregnant women from Asia with GDM have a higher incidence of abnormal glucose tolerance test results post-partum and hence a higher risk of future development of type 2 diabetes mellitus. On the other hand, women from Hispanic or African-American backgrounds with GDM are more likely to develop hypertension post-partum. This review highlights the

  15. Potential positive impact of group-based diabetes dialogue meetings on diabetes distress and glucose control in people with type 1 diabetes

    DEFF Research Database (Denmark)

    Due-Christensen, M; Hommel, E; Ridderstråle, M

    2016-01-01

    OBJECTIVE: To evaluate the effect of group-based diabetes dialogue meetings (DDMs) on diabetes distress, perceived competence and glycaemic control. METHODS: Patients with type 1 diabetes (T1D) were invited to DDMs with peers and healthcare professionals. The impact of participation was evaluated...... no change. Meanwhile, the benefit from participating was rated high with a median of four out of five and the major gain being the possibility to share experiences with peers. CONCLUSION: Group-based DDMs were highly appreciated by participants and associated with significant improvements in diabetes...

  16. Diabetes Support Groups Improve Patient’s Compliance and Control Blood Glucose Levels

    Directory of Open Access Journals (Sweden)

    Zamrotul Izzah

    2013-09-01

    Full Text Available Providing information is not enough to improve diabetic patient’s compliance and achieve goals of therapy. Patient’s good awareness as well as emotional and social supports from family and community may play an important role to improve their compliance and clinical outcomes. Therefore, diabetes support groups were developed and each support group consisted of two pharmacists, two nurses, diabetic patients and their family members. A total of 70 type 2 diabetic patient’s were enrolled and randomized into support group 1 and support group 2. Patients in the group 1 received information leaflets only, while patient in the group 2 received pharmacist counselling and information leaflets at each meeting. Patient’s awareness of diabetes and compliance with medications were assessed by a short questionnaire at baseline and final follow-up. Blood glucose and cholesterol levels were also evaluated in both groups. At the end of study, the overall patient’s awareness and compliance improved by 61.5%. The random and fasting blood glucose levels decreased over than 30% in the group 2 and around 14% in the group 1. This study reveals that collaboration between health care professionals and community in the diabetes support group might help diabetic patients to increase their knowledge and compliance with the diabetes therapy as well as glycaemic control.

  17. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

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    Kaberi Dasgupta

    Full Text Available OBJECTIVE: We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2 prevention program. RESEARCH DESIGN AND METHODS: Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. RESULTS: Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. CONCLUSIONS: Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  18. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Science.gov (United States)

    Dasgupta, Kaberi; Da Costa, Deborah; Pillay, Sabrina; De Civita, Mirella; Gougeon, Réjeanne; Leong, Aaron; Bacon, Simon; Stotland, Stephen; Chetty, V Tony; Garfield, Natasha; Majdan, Agnieszka; Meltzer, Sara

    2013-01-01

    We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program. Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  19. Social Media as a Platform for Information About Diabetes Foot Care: A Study of Facebook Groups.

    Science.gov (United States)

    Abedin, Tasnima; Al Mamun, Mohammad; Lasker, Mohammad A A; Ahmed, Syed Walid; Shommu, Nusrat; Rumana, Nahid; Turin, Tanvir C

    2017-02-01

    Diabetes is one of the most challenging chronic health conditions in the current era. Diabetes-related foot problems need proper patient education, and social media could a play role to disseminate proper information. A systematic search was performed on Facebook groups using the key words "diabetes foot care", "diabetes foot", "diabetes foot management" and "podiatric care". The search resulted in 57 groups and detailed activity information was collected from those groups. Usefulness of each relevant post was determined. Regression analysis was performed to explore the factors associated with the level of usefulness of diabetes foot care-related Facebook groups. Our search resulted in a total of 16 eligible diabetes foot care-related Facebook groups with a total of 103 eligible posts. The average number of group members for the selected groups were 265.75 with an interquartile range of 3.5-107.75. Of the total 103 timeline posts, 45.6% posts were categorized as useful, while the remaining posts were not useful. Top mentioned diabetes foot care practice was "Checking feet daily". Multivariable logistic regression analysis showed that the level of usefulness of diabetes foot care-related Facebook groups were significantly associated with the type of posts and no association was found with presence of "likes" and presence of comment. Facebook being a widely used social networking system, patient welfare organizations, doctors, nurses and podiatrists could use this platform to provide support to educating diabetes patients and their caregivers by disseminating useful and authentic knowledge and information related to diabetes foot care. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  20. A Training and Support Group for Elderly Diabetics: Description and Evaluation.

    Science.gov (United States)

    Robison, Floyd F.

    1993-01-01

    Conducted 12-week diabetes support-training group for older adults having difficulty managing their diabetes because of poor dietary compliance. Results revealed that group participants (n=12 women) successfully improved their compliance to diet plans and lowered their peak blood glucose levels. (Author/NB)

  1. Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

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    Simone R de Bruin

    2013-12-01

    Full Text Available Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups.Methods: We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients’ achievement of recommended clinical outcomes and patients’ perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

  2. Gestational diabetes mellitus in five ethnic groups: a comparison of their clinical characteristics.

    Science.gov (United States)

    Wong, V W

    2012-03-01

    The prevalence of gestational diabetes mellitus has been shown to vary between ethnic groups. The differences in the clinical characteristics and outcomes of women with gestational diabetes mellitus from various ethnic groups have not been clearly defined. A retrospective review of women with gestational diabetes mellitus from a single institution between 2007 and 2010 was conducted. The clinical profiles of women from five ethnic groups (South-East Asian, South Asian, Middle Eastern, Anglo-European and Pacific Islander) were documented, including the outcomes of their pregnancy. In this cohort of 827 women from these five ethnic groups, South-East Asians had the lowest BMI, lowest fasting (yet highest 2-h) glucose level on 75-g glucose tolerance test, lowest need for insulin therapy and lowest rate of macrosomia. South Asians had the lowest parity but strongest family history of diabetes. Their offspring also had the lowest birthweight. Women from Pacific Islands had the highest parity, BMI, fasting glucose levels on 75-g glucose tolerance test, HbA(1c) (at diagnosis of gestational diabetes mellitus as well as at 36 weeks' gestation) and greatest need for insulin therapy. Their offspring also had the highest birthweights. This study highlighted the significant differences in clinical characteristics of women with gestational diabetes mellitus among five ethnic groups. These differences may need to be considered in the management of gestational diabetes mellitus, especially in the interpretation of normality for pregnancy. © 2011 The Author. Diabetic Medicine © 2011 Diabetes UK.

  3. Prevalence of diabetic retinopathy in various ethnic groups: a worldwide perspective.

    Science.gov (United States)

    Sivaprasad, Sobha; Gupta, Bhaskar; Crosby-Nwaobi, Roxanne; Evans, Jennifer

    2012-01-01

    The alarming rise in diabetes prevalence is a global public health and economic problem. Diabetic retinopathy is the most common complication of diabetes and the leading cause of blindness among working-age populations in the Western world. Screening and prompt treatment of diabetic retinopathy are not top priorities in many regions of the world, because the impacts of other causes of preventable blindness remain an issue. Ethnicity is a complex, independent risk factor for diabetic retinopathy. Observations from white populations cannot be extrapolated fully to other ethnic groups. The prevalence of diabetic retinopathy, sight-threatening diabetic retinopathy, and clinically significant macular edema are higher in people of South Asian, African, Latin American, and indigenous tribal descent compared to the white population. Although all ethnic groups are susceptible to the established risk factors of diabetic retinopathy-such as length of exposure and severity of hyperglycemia, hypertension, and hyperlipidemia-ethnic-specific risk factors also may influence these rates. Such risk factors may include differential susceptibility to conventional risk factors, insulin resistance, differences in anthropometric measurements, truncal obesity, urbanization, variations in access to healthcare systems, genetic susceptibility, and epigenetics. The rates of nonproliferative diabetic retinopathy appear to be declining in the United States, supporting the observation that better medical management of diabetes and prompt treatment of sight-threatening diabetic retinopathy substantially improve the long-term diabetic retinopathy incidence; studies from other parts of the world are limited and do not mirror this finding, however. We examine the ethnicity and region-based prevalence of diabetic retinopathy around the world and highlight the need to reinforce ethnicity-based screening and treatment thresholds in diabetic retinopathy. Copyright © 2012 Elsevier Inc. All rights

  4. Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia.

    Science.gov (United States)

    Smith, Cynthia; McNaughton, Darlene A; Meyer, Samantha

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is a progressive chronic disease that requires significant self-surveillance and adherence to the treatment protocols for successful management and future health. There is a growing body of evidence suggesting that diabetes education is beneficial for patient outcomes. However, there is some debate about how best to deliver diabetes education, whether individually or in groups. Although several studies have investigated the role of group education in improving the management of T2DM, few studies have examined this issue from the client's perspective. It is here that this study makes a contribution to understanding diabetes management. Drawing on systematic observation of group education sessions provided by diabetic resource nurses and in-depth interviews with clients, this paper describes the experiences, perspectives and significance of these sessions to clients. Our results suggest that group education sessions were seen as valuable to the clients for: the opportunity they provided to meet others living with diabetes; to improve motivation for managing the disease; and to enhance knowledge of diabetes, its management and long-term implications. In short, this study demonstrates that the clients value group education sessions for the social contact, increasing knowledge about the disease for self-management and support they provide; factors recognised as important to maintaining health. In addition, group education sessions appear to be a cost-effective method for diabetes self-management that funders need to consider.

  5. Pyrroloquinoline quinone (PQQ) has potential to ameliorate streptozotocin-induced diabetes mellitus and oxidative stress in mice: A histopathological and biochemical study.

    Science.gov (United States)

    Kumar, Narendra; Kar, Anand

    2015-10-05

    Enhanced oxidative stress and hyperglycemia are associated with diabetes mellitus (DM). As pyrroloquinoline quinone (PQQ) is known to protect cells from oxidative stress, the present study was undertaken to reveal the hitherto unknown effects of PQQ in DM and associated problems in different tissues. Forty two mice were randomly divided into six groups. Group I receiving only citrate buffer served as the normal control, while group II animals were injected with citrate buffer and PQQ at 20 mg/kg for 15 days and served as test drug control. Animals of groups III-VI were rendered diabetic by single dose of streptozotocin (STZ, 150 mg/kg body weight), following which PQQ at a dose of 5, 10 and 20 mg/kg, was injected to the animals of group IV, V and VI respectively for 15 days. At the end, alterations in serum indices such as glucose, different lipids, insulin, amylase, urea, uric acid, serum glutamate pyruvate transaminase and serum glutamate oxaloacetate transaminase; tissue antioxidants and histopathological alterations in liver, kidney and pancreas were evaluated. STZ-treated animals developed oxidative stress as indicated by a significant increase in tissue lipid peroxidation (LPO) and lipid hydroperoxide, serum glucose, total cholesterol, triglyceride and urea, with a parallel decrease in the levels of serum insulin and tissue antioxidants. When diabetic animals received different doses of PQQ, these adverse effects were ameliorated. However, 20 mg/kg of PQQ appeared to be most effective. Findings revealed for the first time that PQQ has the potential to mitigate STZ-induced DM and oxidative damage in different organs of mice, suggesting that it may ameliorate diabetes mellitus and associated problems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?

    DEFF Research Database (Denmark)

    Due-Christensen, Mette; Zoffmann, Vibeke; Hommel, Eva

    2012-01-01

    included patients with Type 1 diabetes aged = 21 years, having been diagnosed = 1 year earlier. Primary outcome was diabetes-related distress (using the Problem Areas in Diabetes scale). Secondary outcomes were psychological distress and depressive symptoms (Symptom Check List -90-R/Global Severity Index...... and depression subscale), well-being (World Health Organization 5) and HbA1c. Results Equal numbers of patients with HbA1c above and below 64 mmol/mol (8%) joined the support groups (n = 54). Focus group interviews revealed that major benefits were feeling less alone and being intuitively understood among peers....... Conclusions Support groups are able to reduce diabetes-related and psychological distress 1 year after the intervention for patients with both good and poor glycaemic control displaying high levels of distress. Although patients with severely high levels of diabetes-related distress might need more extensive...

  7. An Education-Support-Group Program for Visually Impaired People with Diabetes.

    Science.gov (United States)

    Caditz, J.

    1992-01-01

    This article describes the Diabetes Education/Support Group Program for people with diabetes and visual impairment. It analyzes some of the common problems that participants have reported (such as fear of insulin reactions and of long-term complications) and discusses methods of reducing anxiety and depression related to the two conditions.…

  8. The association of physical inactivity with Type 2 diabetes among different ethnic groups

    NARCIS (Netherlands)

    Admiraal, W. M.; van Valkengoed, I. G. M.; L de Munter, J. S.; Stronks, K.; Hoekstra, J. B. L.; Holleman, F.

    2011-01-01

    Diabet. Med. 28, 668-672 (2011) ABSTRACT: Aims  To study differences in the association between physical inactivity and Type 2 diabetes among subjects from different ethnic groups. Methods  We analysed data on 508 Caucasian, 596 African-Surinamese and 339 Hindustani-Surinamese participants, aged

  9. Phenotyping animal models of diabetic neuropathy: a consensus statement of the diabetic neuropathy study group of the EASD (Neurodiab).

    Science.gov (United States)

    Biessels, G J; Bril, V; Calcutt, N A; Cameron, N E; Cotter, M A; Dobrowsky, R; Feldman, E L; Fernyhough, P; Jakobsen, J; Malik, R A; Mizisin, A P; Oates, P J; Obrosova, I G; Pop-Busui, R; Russell, J W; Sima, A A; Stevens, M J; Schmidt, R E; Tesfaye, S; Veves, A; Vinik, A I; Wright, D E; Yagihashi, S; Yorek, M A; Ziegler, D; Zochodne, D W

    2014-06-01

    NIDDK, JDRF, and the Diabetic Neuropathy Study Group of EASD sponsored a meeting to explore the current status of animal models of diabetic peripheral neuropathy. The goal of the workshop was to develop a set of consensus criteria for the phenotyping of rodent models of diabetic neuropathy. The discussion was divided into five areas: (1) status of commonly used rodent models of diabetes, (2) nerve structure, (3) electrophysiological assessments of nerve function, (4) behavioral assessments of nerve function, and (5) the role of biomarkers in disease phenotyping. Participants discussed the current understanding of each area, gold standards (if applicable) for assessments of function, improvements of existing techniques, and utility of known and exploratory biomarkers. The research opportunities in each area were outlined, providing a possible roadmap for future studies. The meeting concluded with a discussion on the merits and limitations of a unified approach to phenotyping rodent models of diabetic neuropathy and a consensus formed on the definition of the minimum criteria required for establishing the presence of the disease. A neuropathy phenotype in rodents was defined as the presence of statistically different values between diabetic and control animals in 2 of 3 assessments (nocifensive behavior, nerve conduction velocities, or nerve structure). The participants propose that this framework would allow different research groups to compare and share data, with an emphasis on data targeted toward the therapeutic efficacy of drug interventions. © 2014 Peripheral Nerve Society.

  10. Food intake of individuals with and without diabetes across different countries and ethnic groups.

    Science.gov (United States)

    Nöthlings, U; Boeing, H; Maskarinec, G; Sluik, D; Teucher, B; Kaaks, R; Tjønneland, A; Halkjaer, J; Dethlefsen, C; Overvad, K; Amiano, P; Toledo, E; Bendinelli, B; Grioni, S; Tumino, R; Sacerdote, C; Mattiello, A; Beulens, J W J; Iestra, J A; Spijkerman, A M W; van der A, D L; Nilsson, P; Sonestedt, E; Rolandsson, O; Franks, P W; Vergnaud, A-C; Romaguera, D; Norat, T; Kolonel, L N

    2011-05-01

    Given the importance of nutrition therapy in diabetes management, we hypothesized that food intake differs between individuals with and without diabetes. We investigated this hypothesis in two large prospective studies including different countries and ethnic groups. Study populations were the European Prospective Investigation into Cancer and Nutrition Study (EPIC) and the Multiethnic Cohort Study (MEC). Dietary intake was assessed by food frequency questionnaires, and calibrated using 24h-recall information for the EPIC Study. Only confirmed self-reports of diabetes at cohort entry were included: 6192 diabetes patients in EPIC and 13 776 in the MEC. For the cross-sectional comparison of food intake and lifestyle variables at baseline, individuals with and without diabetes were matched 1:1 on sex, age in 5-year categories, body mass index in 2.5 kg/m(2) categories and country. Higher intake of soft drinks (by 13 and 44% in the EPIC and MEC), and lower consumption of sweets, juice, wine and beer (>10% difference) were observed in participants with diabetes compared with those without. Consumption of vegetables, fish and meat was slightly higher in individuals with diabetes in both studies, but the differences were ethnic groups than countries, but generally showed largely similar patterns. Although diabetes patients are expected to undergo nutritional education, we found only small differences in dietary behavior in comparison with cohort members without diabetes. These findings suggest that emphasis on education is needed to improve the current behaviors to assist in the prevention of complications.

  11. An Innovative Sequential Focus Group Method for Investigating Diabetes Care Experiences With Indigenous Peoples in Canada

    Directory of Open Access Journals (Sweden)

    Kristen Jacklin

    2016-10-01

    Full Text Available This article describes the innovative use of sequential focus groups (SFGs with Indigenous adults living with type 2 diabetes. This use of SFGs has not been previously described in the literature. In our project, SFGs were used to explore Indigenous people’s experiences in managing their diabetes. Our research objective has been to elucidate deep understandings of these experiences in order to inform the development of continuing medical education curriculum with the aim of improving approaches to diabetes care for Indigenous people. Working in partnerships with Indigenous health organizations, we recruited four groups comprising participants from diverse Indigenous communities (two urban, two rural in three provinces of Canada. We conducted a series of five focus groups (SFGs with the same participants (6–8 participants at each site for a total of 20 focus groups and 29 participants. Indigenous people living with type 2 diabetes were asked open-ended questions concerning their experiences with diabetes and diabetes care in primary health-care settings. Our findings concerning the use of SFGs for Indigenous health research draw on team member and participants’ reflections captured in facilitator field notes, memos from debriefing sessions, and focus group transcripts. The SFG approach enabled in-depth exploration of the complex, and at times sensitive, issues related to Indigenous people’s views on diabetes and their experiences of diabetes care. The repeated sessions facilitated comfort and camaraderie among participants, which led to insightful sessions filled with personal and emotional stories of living with diabetes, the impacts of colonization, and health-care experiences. Overall, the method fostered a deeper level of engagement, exploration, and reflection than a single-session focus group typically would. We suggest this adaptation of the traditional single-session focus groups would be applicable to a wide variety of research

  12. Developing and Psychometrically Testing the Functions of Diabetes Peer Support Group Scale.

    Science.gov (United States)

    Chiou, Chii-Jun; Huang, Hsiao-Ling; Lin, Ying-Chun; Wang, Ruey-Hsia

    2016-12-01

    Peer support groups for people with diabetes are increasingly considered a part of the healthcare system. Understanding the functions of peer support groups assist healthcare professionals to provide critical assistance. The purpose of this study was to develop and assess the psychometric properties of the Functions of Diabetes Peer Support Group (F-DPSG) scale. This study used a cross-sectional design. A 16-item F-DPSG scale was developed and administered to 589 patients with Type 2 diabetes who were selected from 34 diabetes peer support groups in Taiwan. Construct validity was evaluated using exploratory and confirmatory factor analyses and by examining the correlation with the score of the Chinese Diabetes Management Self-Efficacy Scale. Reliability was tested using internal consistency and test-retest reliability. The 16-item F-DPSG scale, including four subscales, was supported by a second-order confirmatory factor analysis, with the following fit indices: χ/df ratio = 2.60, comparative fit index = .94, normed fit index = .91, and root mean square error of approximation = .07. The four subscales were "enhancing self-care practice," "obtaining knowledge and skills," "psychological support," and "collective identification." The score of the F-DPSG scale correlated significantly with the score of the Chinese Diabetes Management Self-Efficacy Scale (r = .45, p peer support groups for people with diabetes and to provide necessary assistance.

  13. Adolescent views of diabetes-related parent conflict and support: a focus group analysis.

    Science.gov (United States)

    Weinger, K; O'Donnell, K A; Ritholz, M D

    2001-11-01

    To increase understanding of adolescent-parent diabetes-related conflicts and supports in the management of type 1 diabetes by means of a focus group research approach. Twenty-four adolescents (10 boys and 14 girls, age 13-15 years; 97% white) participated in three same-sex focus groups at two diabetes summer camps. The focus group leader used a prepared set of open-ended questions to guide the 90-minute sessions. Sessions were tape-recorded, transcribed, and analyzed by a set procedure for qualitative analysis to identify the adolescents' perspectives on parent-adolescent sources of diabetes-related conflict and support. Adolescents reported the following sources of diabetes-related conflict: parental worry and intrusive behaviors; parental lack of understanding and blaming behaviors, and the parents focus on the future vs. the adolescent focus on the present. With regard to diabetes-related support, the teens identified parental understanding of the demands of diabetes and parental provision of reassurance about their child's illness and normative functioning. Adolescents' perceptions of parental worry, lack of understanding, and resulting intrusive and blaming behaviors are major areas of conflict that need to be addressed in the management of type 1 diabetes.

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

    Directory of Open Access Journals (Sweden)

    Hamid Reza Abdolsamadi

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

  15. Safety of aerobic exercise in people with diabetic peripheral neuropathy: single-group clinical trial

    National Research Council Canada - National Science Library

    Kluding, Patricia M; Pasnoor, Mamatha; Singh, Rupali; D'Silva, Linda J; Yoo, Min; Billinger, Sandra A; LeMaster, Joseph W; Dimachkie, Mazen M; Herbelin, Laura; Wright, Douglas E

    2015-01-01

    .... This was a single-group preliminary study. The setting was an academic medical center. Participants were 18 people who were sedentary and had type 2 diabetes and peripheral neuropathy (mean age=58.1 years, SD=5...

  16. Succination of Thiol Groups in Adipose Tissue Proteins in Diabetes

    Science.gov (United States)

    Frizzell, Norma; Rajesh, Mathur; Jepson, Matthew J.; Nagai, Ryoji; Carson, James A.; Thorpe, Suzanne R.; Baynes, John W.

    2009-01-01

    S-(2-Succinyl)cysteine (2SC) is formed by reaction of the Krebs cycle intermediate fumarate with cysteine residues in protein, a process termed succination of protein. Both fumarate and succination of proteins are increased in adipocytes cultured in high glucose medium (Nagai, R., Brock, J. W., Blatnik, M., Baatz, J. E., Bethard, J., Walla, M. D., Thorpe, S. R., Baynes, J. W., and Frizzell, N. (2007) J. Biol. Chem. 282, 34219–34228). We show here that succination of protein is also increased in epididymal, mesenteric, and subcutaneous adipose tissue of diabetic (db/db) mice and that adiponectin is a major target for succination in both adipocytes and adipose tissue. Cys-39, which is involved in cross-linking of adiponectin monomers to form trimers, was identified as a key site of succination of adiponectin in adipocytes. 2SC was detected on two of seven monomeric forms of adiponectin immunoprecipitated from adipocytes and epididymal adipose tissue. Based on densitometry, 2SC-adiponectin accounted for ∼7 and 8% of total intracellular adiponectin in cells and tissue, respectively. 2SC was found only in the intracellular, monomeric forms of adiponectin and was not detectable in polymeric forms of adiponectin in cell culture medium or plasma. We conclude that succination of adiponectin blocks its incorporation into trimeric and higher molecular weight, secreted forms of adiponectin. We propose that succination of proteins is a biomarker of mitochondrial stress and accumulation of Krebs cycle intermediates in adipose tissue in diabetes and that succination of adiponectin may contribute to the decrease in plasma adiponectin in diabetes. PMID:19592500

  17. Adaptive changes in renal mitochondrial redox status in diabetic nephropathy

    Energy Technology Data Exchange (ETDEWEB)

    Putt, David A.; Zhong, Qing; Lash, Lawrence H., E-mail: l.h.lash@wayne.edu

    2012-01-15

    Nephropathy is a serious and common complication of diabetes. In the streptozotocin (STZ)-treated rat model of diabetes, nephropathy does not typically develop until 30 to 45 days post-injection, although hyperglycemia occurs within 24 h. We tested the hypothesis that chronic hyperglycemia results in a modest degree of oxidative stress that is accompanied by compensatory changes in certain antioxidants and mitochondrial redox status. We propose that as kidneys progress to a state of diabetic nephropathy, further adaptations occur in mitochondrial redox status. Basic parameters of renal function in vivo and several parameters of mitochondrial function and glutathione (GSH) and redox status in isolated renal cortical mitochondria from STZ-treated and age-matched control rats were examined at 30 days and 90 days post-injection. While there was no effect of diabetes on blood urea nitrogen, measurement of other, more sensitive parameters, such as urinary albumin and protein, and histopathology showed significant and progressive worsening in diabetic rats. Thus, renal function is compromised even prior to the onset of frank nephropathy. Changes in mitochondrial respiration and enzyme activities indicated existence of a hypermetabolic state. Higher mitochondrial GSH content and rates of GSH transport into mitochondria in kidneys from diabetic rats were only partially due to changes in expression of mitochondrial GSH carriers and were mostly due to higher substrate supply. Although there are few clear indicators of oxidative stress, there are several redox changes that occur early and change further as nephropathy progresses, highlighting the complexity of the disease. Highlights: ►Adaptive changes in renal mitochondrial and redox status in diabetic rats. ►Modest renal dysfunction even prior to onset of nephropathy. ►Elevated concentrations of mitochondrial GSH in diabetic kidneys. ►Change in GSH due partly to increased protein expression of transporter.

  18. Streptozotocin-induced diabetes decreases conducted vasoconstrictor response in mouse cremaster arterioles

    DEFF Research Database (Denmark)

    Rai, A; Riemann, M; Gustafsson, F

    2008-01-01

    A conducted vasomotor response (CVR) is characterized by the spread of vasoconstriction or vasodilatation both up- and downstream from a local stimulation site in the microcirculation. It is believed to coordinate vasomotor responses within the microcirculation, and to contribute to the control....... The mouse cremasteric arterioles were stimulated locally with KCl and the resulting local response as well as conducted responses at 500 microm and 1000 microm were measured in control and STZ treated mice. Diabetes (n=8) induced by intraperitoneal injection of STZ in a dose of 100 mg/kg (mean blood glucose...

  19. Effects of Group Counseling on Self-care Behaviors in Menopausal Women with Diabetes.

    Science.gov (United States)

    Parsa, Parisa; Ahmadinia Tabesh, Roya; Soltani, Farzaneh; Karami, Manoocher; Khorami, Nasrin

    2017-08-01

    Diabetes is a chronic disease which is common in menopause period. Performing self-care behaviors is effective method for control of diabetes. This study aimed to investigate the effect of counseling on self-care behaviors in menopause diabetes women in 2016 in Hamadan, Iran. In this study, 80 menopausal women were randomly selected and allocated to the experimental and control groups (40 per group). Data collected by a questionnaire included of demographic information, self-care behaviors, fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c). In the experimental group, training program was run during four sessions in the form of weekly group consulting sessions. During this period, the control group only received routine cares. Three months after intervention (group consultation) self-care behaviors, FBS and HbA1c were compared between two groups. Data were analyzed using SPSS 16 software. The self-care score in the experimental group increased from 49.6 ± 12.2 before the intervention to 66.6 ± 9.3 after the intervention (P control group average of self-care score changed from 57.6 ± 11.5 to 62.0 ± 11.6 (P control group. The results showed that group counseling promoted self-care behaviors and metabolic indices in menopausal diabetic patients.

  20. Acute bout of exercise induced prolonged muscle glucose transporter-4 translocation and delayed counter-regulatory hormone response in type 1 diabetes.

    Directory of Open Access Journals (Sweden)

    Koji Sato

    Full Text Available Previous studies have demonstrated that an acute bout of aerobic exercise induces a subsequent delayed onset of hypoglycemia among patients with type 1 diabetes. However, the mechanisms of exercise-induced hypoglycemia in type 1 diabetes are still unclear. Streptozotocin (STZ was injected to 6-week-old male Wistar rats, and three days after STZ injection, animals were randomly assigned into 2 groups: STZ with insulin only (STZ and STZ with insulin and exercise (STZ+EX. Normal Wistar rats with exercise were used as control (CON+EX. Insulin was intraperitoneally injected (0.5 U/kg to both STZ groups (-0.5 h, and a bout of aerobic exercise (15 m/min for 30 min was conducted at euglycemic conditions (0 h. Blood was collected at 0, 1, 3, and 5 h after exercise from the carotid artery. While the blood glucose level was stable during the post-exercise period (0-5 h in the STZ and CON+EX groups, it decreased significantly only in the STZ+EX group at 3 h. Plasma glucagon, adrenalin, and noradrenalin levels significantly increased at 1 h in the STZ group, whereas significant hormonal responses were observed at 5 h in the STZ+EX group. In skeletal muscle glucose metabolism-related pathway, the level of glucose transporter-4 (GLUT-4 translocation was significantly higher at 1 h in the CON and STZ groups. However, in the STZ+EX group, these activations were maintained by 5 h, indicating a sustained glucose metabolism in the STZ+EX group. A single bout of aerobic exercise induced a delayed onset of hypoglycemia in STZ-treated rats. A prolonged enhancement of GLUT-4 translocation and delayed counter-regulatory hormone responses may have contributed to the induction of hypoglycemia.

  1. Group participants? experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus

    OpenAIRE

    Kate Odgers-Jewell; Isenring, Elisabeth A.; Rae Thomas; Dianne P Reidlinger

    2017-01-01

    Objective The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants? experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of...

  2. Using computerized text analysis to assess communication within an Italian type 1 diabetes Facebook group

    Directory of Open Access Journals (Sweden)

    Alda Troncone

    2015-11-01

    Full Text Available The purpose of this study was to assess messages posted by mothers of children with type 1 diabetes in the Italian Facebook group “Mamme e diabete” using computerized text analysis. The data suggest that these mothers use online discussion boards as a place to seek and provide information to better manage the disease’s daily demands—especially those tasks linked to insulin correction and administration, control of food intake, and bureaucratic duties, as well as to seek and give encouragement and to share experiences regarding diabetes and related impact on their life. The implications of these findings for the management of diabetes are discussed.

  3. Current Status of Diabetic Peripheral Neuropathy in Korea: Report of a Hospital-Based Study of Type 2 Diabetic Patients in Korea by the Diabetic Neuropathy Study Group of the Korean Diabetes Association

    Directory of Open Access Journals (Sweden)

    Jong Chul Won

    2014-02-01

    Full Text Available Diabetic peripheral neuropathy (DPN is the most common complication associated with diabetes. DPN can present as a loss of sensation, may lead to neuropathic ulcers, and is a leading cause of amputation. Reported estimates of the prevalence of DPN vary due to differences in study populations and diagnostic criteria. Furthermore, the epidemiology and clinical characteristics of DPN in Korean patients with type 2 diabetes mellitus (T2DM are not as well understood as those of other complications of diabetes such as retinal and renal disease. Recently, the Diabetic Neuropathy Study Group of the Korean Diabetes Association (KDA conducted a study investigating the impact of DPN on disease burden and quality of life in patients with T2DM and has published some data that are representative of the nation. This review investigated the prevalence and associated clinical implications of DPN in Korean patients with diabetes based on the KDA study.

  4. International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis: further evidence from China.

    Science.gov (United States)

    Wei, Yumei; Yang, Huixia; Zhu, Weiwei; Yang, Hongyun; Li, Haixia; Yan, Jie; Zhang, Cuilin

    2014-01-01

    The International Association of Diabetes and Pregnancy Study Group (IADPSG) recommended new diagnostic criteria for gestational diabetes mellitus (GDM) after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group (NDDG) or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% (P criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section (62.3%) and macrosomia (14.8%) was the highest in untreated mild GDM patients. Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.

  5. The Effect of Group Reminiscence Therapy on Depression in Women With Type II Diabetes

    Directory of Open Access Journals (Sweden)

    Jooj

    2016-01-01

    Full Text Available Background Diabetes mellitus is associated with an increased risk of psychological disorders and symptoms. Objectives This research investigated the effect of group reminiscence therapy on depression among women with type II diabetes. Patients and Methods The present study was a clinical trial study. Twenty-four patients referring to the diabetic clinic of Golestan hospital in Ahvaz, Iran were selected through simple random sampling and were divided in two groups. Data were collected through a demographic questionnaire and the Beck Depression Inventory. Group reminiscence therapy was held over eight biweekly sessions, each lasting 90 minutes. Finally, data were analyzed through descriptive statistics and the Mann-Whitney, Friedman, and Chi-Square tests, using SPSS version 20. Results A significant difference was observed between the two groups after the intervention (P = 0.001. The rating for depression decreased significantly in the experimental group. Before the group reminiscence therapy, the highest rating for depression obtained by the experimental group was “need for consultation” (50%, whereas after the intervention, the highest rating was “no depression” (50%. One month after the intervention, the highest rating obtained for depression was “low” (50%. Conclusions Reminiscence therapy decreased depression among diabetic female patients after the intervention and one month after the intervention. It can be said that, through the reminiscence therapy, patients’ past memories were reviewed and emphasis on the positive aspects thereof in the group setting was followed by an increased sense of self-worth and a decrease in depression.

  6. Unacylated ghrelin and obestatin increase islet cell mass and prevent diabetes in streptozotocin-treated newborn rats.

    Science.gov (United States)

    Granata, Riccarda; Volante, Marco; Settanni, Fabio; Gauna, Carlotta; Ghé, Corrado; Annunziata, Marta; Deidda, Barbara; Gesmundo, Iacopo; Abribat, Thierry; van der Lely, Aart-Jan; Muccioli, Giampiero; Ghigo, Ezio; Papotti, Mauro

    2010-07-01

    The ghrelin gene products, namely acylated ghrelin (AG), unacylated ghrelin (UAG), and obestatin (Ob), were shown to prevent pancreatic beta-cell death and to improve beta-cell function under treatment with cytokines, which are major cause of beta-cell destruction in diabetes. Moreover, AG had been described previously to prevent streptozotocin (STZ)-induced diabetes in rats; however, the effect of either UAG or Ob has never been examined in this context. In the present study, we investigated the potential of UAG and Ob to increase islet beta-cell mass and to reduce diabetes at adult age in STZ-treated neonatal rats. One-day-old rats were injected with STZ and subsequently administered with either AG, UAG or Ob for 7 days. On day 70, plasma glucose levels, plasma and pancreatic insulin levels, pancreatic islet area and number, insulin and pancreatic/duodenal homeobox-1 (Pdx1) gene expression, and antiapoptotic BCL2 protein expression were determined. Similarly to AG, both UAG and Ob counteracted STZ-induced high glucose levels and improved plasma and pancreatic insulin levels, which were reduced by the diabetogenic compound. UAG and Ob increased islet area, islet number, and beta-cell mass with respect to STZ treatment alone. Finally, in STZ-treated animals, UAG and Ob up-regulated insulin and Pdx1 mRNA and increased the expression of BCL2 similarly to AG. Taken together, our results suggest that in STZ-treated newborn rats, UAG and Ob improve glucose metabolism and preserve islet cell mass, granting a therapeutic potential in medical conditions associated with impaired beta-cell function.

  7. [Diabetes mellitus and cardiovascular risk: Working group recommendations of Diabetes and Cardiovascular Disease of the Spanish Society of Diabetes (SED, 2015)].

    Science.gov (United States)

    Arrieta, Francisco; Iglesias, Pedro; Pedro-Botet, Juan; Tébar, Francisco Javier; Ortega, Emilio; Nubiola, Andreu; Pardo, Jose Luis; Maldonado, Gonzálo Fernando; Obaya, Juan Carlos; Matute, Pablo; Petrecca, Romina; Alonso, Nuria; Sarabia, Elena; Sánchez-Margalet, Victor; Alemán, José Juan; Navarro, Jorge; Becerra, Antonio; Duran, Santiago; Aguilar, Manuel; Escobar-Jiménez, Fernando

    2015-01-01

    The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  8. [Diabetes mellitus and cardiovascular risk: Working group recommendations of Diabetes and Cardiovascular Disease of the Spanish Society of Diabetes (SED, 2015)].

    Science.gov (United States)

    Arrieta, Francisco; Iglesias, Pedro; Pedro-Botet, Juan; Tébar, Francisco Javier; Ortega, Emilio; Nubiola, Andreu; Pardo, Jose Luis; Maldonado, Gonzálo Fernando; Obaya, Juan Carlos; Matute, Pablo; Petrecca, Romina; Alonso, Nuria; Sarabia, Elena; Sánchez-Margalet, Victor; Alemán, José Juan; Navarro, Jorge; Becerra, Antonio; Duran, Santiago; Aguilar, Manuel; Escobar-Jiménez, Fernando

    2016-05-01

    The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  9. Subjective quality of life of outpatients with diabetes: comparison with family caregivers' impressions and control group.

    Science.gov (United States)

    Awadalla, Abdel W; Ohaeri, Jude U; Tawfiq, Adel M; Al-Awadi, Shafika A

    2006-05-01

    There is a paucity of studies on comparison of quality of life (QOL) of type-1 and type-2 diabetes patients, and the impact of family caregivers' impressions on the QOL of patients. To assess the subjective QOL of Sudanese diabetics using the WHOQOL-Bref, compared with a general population sample; examine caregiver-patient concordance; and assess the variables that impact on QOL. The responses of 105 outpatients with type-1 diabetes and 136 with type-2 diabetes were compared with their family caregivers' impressions and 139 general population subjects. Patients were predominantly dissatisfied with their life circumstances. Type-1 diabetics had significantly lowest QOL scores, while the control group had highest scores. Having additional medical problems; having diminished sexual desire; and being young, unemployed and single were associated with poor QOL, but illness duration was not. Type-2 diabetics had lesser concordance with caregivers. The only predictor of patients' QOL was the caregivers' impression of patients' QOL. Caregivers' impression of patients' QOL impacted on outcome. Caregiver education is, therefore, important. The factors associated with QOL indicate a group that needs focused attention. The good QOL for type-2 and nonsignificance of illness duration encourage therapeutic optimism.

  10. An online monogenic diabetes discussion group: supporting families and fueling new research.

    Science.gov (United States)

    Perrone, Marie E; Carmody, David; Philipson, Louis H; Greeley, Siri Atma W

    2015-11-01

    Many online support groups are available for patients with rare disorders, but scant evidence is available on how effectively such groups provide useful information or valuable psychosocial support to their participants. It is also unclear to what extent physicians and researchers may learn more about these disorders by participating in such groups. To formally assess the utility of the Kovler Monogenic Diabetes Registry online discussion group for patients and families affected by KATP channel-related monogenic neonatal diabetes in providing psychosocial and informational support and in identifying concerns unique to patients with this rare form of diabetes. We qualitatively analyzed all 1,410 messages from the online group that consisted of 64 participants affected by KATP channel monogenic diabetes and 11 researchers. We utilized the Social Behavior Support Code to assign each message to a support category and deductive thematic analysis to identify discussion topics addressed by each message. 44% of messages provided/requested informational support, whereas 31.4% of the messages contained psychosocial/emotional support. The most popular topics of postings to the forums were diabetes treatment (503 messages) and neurodevelopmental concerns (472 messages). Participation in the discussion led researchers to modify survey instruments and design new studies focusing on specific topics of concern, such as sleep. We demonstrate that an online support group for a monogenic form of diabetes is an effective informational tool that also provides psychosocial support. Participation by researchers and care providers can inform future research directions and highlight issues of patient concern. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Potential antidiabetic and hypolipidemic effects of propolis extract in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    El-Sayed, El-Sayed M; Abo-Salem, Osama M; Aly, Hamdy A; Mansour, Ahmed M

    2009-04-01

    Free radicals have been implicated in the pathogenesis of diabetes mellitus leading to various complications including atherosclerosis. Propolis was reported to have oxygen radical scavenging activity. The present study was designed to investigate the possible antidiabetic, hypolipidemic and antioxidant effects of ethanolic extract of propolis (EEP). Type capital I, Ukrainian diabetes was induced in rats by injection of streptozotocin (STZ) in a dose of 60 mg/kg bwt, i.p. for 3 consecutive days. After 5 weeks of STZ injection, there were an apparent reduction in the animal body weight amounting to 21% and significant increases in serum glucose (184%), triglycerides (63%), total cholesterol (43%) and low density lipoprotein-cholesterol (LDL-C) (148%) with a concomitant decrease in serum high density lipoprotein-cholesterol (HDL-C) (51%) as compared to the control normal group. In addition, there was significant elevation in pancreatic lipid peroxides measured as malondialdehyde (MDA) and serum nitric oxide (NO) amounting to 185% and 224%, respectively with marked reduction in serum reduced glutathione (GSH) and catalase (CAT) (66% and 31%, respectively) and pancreatic superoxide dismutase (SOD) (54%) in STZ-treated rats. On the other hand, oral daily treatment of animals with EEP in a dose of 200 mg/kg bwt for a period of 5 weeks ameliorated STZ-induced alterations in the animal body weight as well as in serum glucose, lipids, lipoproteins, NO, GSH & CAT and pancreatic MDA & SOD. In conclusion, propolis extract offers promising antidiabetic and hypolipidemic effects that may be mainly attributed to its potent antioxidant potential. Further studies will be needed in future in order to determine which one(or more) of its active constituents has the main antidiabetic and hypolipidemic effects.

  12. Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: The Copenhagen Type 2 Diabetes Rehabilitation Project

    DEFF Research Database (Denmark)

    Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert

    2011-01-01

    To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....

  13. Psychoeducative groups help control type 2 diabetes in a primary care setting.

    Science.gov (United States)

    Cervantes Cuesta, Miguel Ángel; García-Talavera Espín, Noelia Victoria; Brotons Román, Josefa; Núñez Sánchez, M Ángeles; Brocal Ibáñez, Pedro; Villalba Martín, Pilar; Saura García, Carmen; Sánchez Esteban, Tomasa; Romero López-Reinoso, Helena; Delgado Aroca, Ma José; Sánchez Gil, Dolores; Meoro Avilés, Amparo; Soriano Palao, José

    2013-01-01

    The purpose of this study is to measure the impact of a psychoeducational group intervention in diabetes using glycosylated haemoglobin (HbA1c), the body mass index (BMI) and cardiovascular risk factors (CVRF) compared with conventional educational measures provided individually. A quasi-experimental study (pre/post-intervention) with a non-equivalent control group was conducted, including 72 type 2 individuals with diabetes (mean data: age 63.08 years, HbA1C 6.98%, BMI 30.48 kg/m2).The beneficial effect of psychoeducational group therapy in the study group (PGT) was compared with conventional diabetes education in the control group (CG). The PGT had a higher mean HbA1c reduction (-0.51 ± 1.7 vs. -0.06 ± 0.53%, p 0.003), met the objectives of optimal control of HbA1c to a higher degree (80% vs. 48%, p 0.005) and greater mean weight reduction (-1.93 ± 3.57 vs. 0.52 ± 1.73 kg, p 0002) than the CG.A significant improvement in total cholesterol, LDL cholesterol, triglycerides, systolic and diastolic blood pressure was achieved in PGT (all p programs should be considered to introduce these more efficient therapies for diabetes education in primary care. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  14. Non-obese diabetic mice rapidly develop dramatic sympathetic neuritic dystrophy: a new experimental model of diabetic autonomic neuropathy.

    Science.gov (United States)

    Schmidt, Robert E; Dorsey, Denise A; Beaudet, Lucie N; Frederick, Kathy E; Parvin, Curtis A; Plurad, Santiago B; Levisetti, Matteo G

    2003-11-01

    To address the pathogenesis of diabetic autonomic neuropathy, we have examined the sympathetic nervous system in non-obese diabetic (NOD) and streptozotocin (STZ)-induced diabetic mice, two models of type 1 diabetes, and the db/db mouse, a model of type 2 diabetes. After only 3 to 5 weeks of diabetes, NOD mice developed markedly swollen axons and dendrites ("neuritic dystrophy") in the prevertebral superior mesenteric and celiac ganglia (SMG-CG), similar to the pathology described in diabetic STZ- and BBW-rat and man. Comparable changes failed to develop in the superior cervical ganglia of the NOD mouse or in the SMG-CG of non-diabetic NOD siblings. STZ-induced diabetic mice develop identical changes, although at a much slower pace and to a lesser degree than NOD mice. NOD-SCID mice, which are genetically identical to NOD mice except for the absence of T and B cells, do not develop diabetes or neuropathology comparable to diabetic NOD mice. However, STZ-treated NOD-SCID mice develop severe neuritic dystrophy, evidence against an exclusively autoimmune pathogenesis for autonomic neuropathy in this model. Chronically diabetic type 2 db/db mice fail to develop neuritic dystrophy, suggesting that hyperglycemia alone may not be the critical and sufficient element. The NOD mouse appears to be a valuable model of diabetic sympathetic autonomic neuropathy with unambiguous, rapidly developing neuropathology which corresponds closely to the characteristic pathology of other rodent models and man.

  15. Effectiveness of individual and group interventions for people with type 2 diabetes1

    Science.gov (United States)

    Imazu, Maria Fernanda Manoel; Faria, Barbara Nascimento; de Arruda, Guilherme Oliveira; Sales, Catarina Aparecida; Marcon, Sonia Silva

    2015-01-01

    OBJECTIVE: to compare the effectiveness of two educational interventions used by a healthcare provider in the monitoring of individuals with type 2 diabetes mellitus (T2DM), regarding knowledge of the disease, impact on quality of life and adoption of self-care actions. METHODS: comparative, longitudinal, prospective study performed with 150 subjects with type 2 diabetes, analyzed according to the type of participation in the program (individual and/or group). Participants of the individual intervention (II) received nursing consultations every six months and those of the group intervention (GI) took part in weekly meetings for three months. Data were collected through four questionnaires: Identification questionnaire, Problem Areas in Diabetes Questionnaire (PAID), Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the Diabetes Knowledge Scale (DKN-A). Data were analyzed using the Friedman and Mann Whitney tests, considering a statistical significance of p ≤ 0.05. RESULTS: there was an increase in knowledge about the disease in the II (p<0.003) and GI (p<0.007), with reduction of the impact on the quality of life in the II (p<0.007) and improvement in self-care actions in the GI (p<0.001). CONCLUSION: in both intervention models improvements were observed in the indicators, over the six month monitoring period. PMID:26039289

  16. Re-Training of Type 2 Diabetic Patients for Better Adherence to Diabetes Care Plan in Oral Anti-Diabetics and Plus Insulin Treatment Groups

    Directory of Open Access Journals (Sweden)

    Soner Cander

    2015-06-01

    Full Text Available Purpose: This prospective observational single-centre study was designed to evaluate the effect of patient re-training for better adherence to regular self-monitoring of blood glucose (SMBG, standard diabetic diet and exercise program in ambulatory patients with type 2 diabetes mellitus (T2DM receiving oral anti-diabetic (OAD and OAD plus insulin treatments. Material and Method: In this study, we enrolled a total of 61 patients with T2DM in whom ongoing therapy with OAD (n=34 and OAD+insulin (n=27 failed to achieve adequate glycemic control. The patients were educated for lifestyle behavior, adherence to diet and exercise therapy, close monitoring with SMBG without change in their ongoing drugs and dosing. Changes in glycemic parameters, serum lipids and anthropometrics at the end of 3rd month were compared between the treatment groups. Results: During the course of the study, a significant decrease in the body weight and fat were observed in OAD (p<0.001 and p=0.002 and OAD+insulin groups (p=0.044 and p=0.008, respectively. A significant decrease in the HbA1c % (6.1%; 8.2% to 7.6% was observed in the overall population (p<0.001 as well as in OAD (p=0.011 and OAD+insulin (p=0.001 groups. A significant decrease was noted in the post-prandial capillary blood glucose levels in only OAD+insulin group. Discussion: Re-training approach with close follow-up and frequent SMBG seems to be important factors for the maintenance of achieved glycemic control. In our study, the effect of diabetes education on postprandial capillary blood glucose levels was more pronounced in OAD+insulin group. Turk Jem 2015; 19: 49-54

  17. [Food groups for the investigation of risk of type 2 diabetes and associated diseases].

    Science.gov (United States)

    Nishimura, Renata Yumi; Damião, Renata; Gimeno, Suely Godoy Agostinho; Ferreira, Sandra Roberta Gouveia; Sartorelli, Daniela Saes

    2011-09-01

    The food groups conventionally applied in activities of nutritional counseling were established according to their macronutrient content. However, it does not consider recent scientific evidences of the association between food consumption and risk of developing non-communicable chronic diseases. To propose food groups for the investigation of the association between food consumption and risk of developing type 2 diabetes and associated diseases among Japanese-Brazilians. Cross-sectional analysis of baseline data of a lifestyle intervention study conducted among Japanese-Brazilians of Bauru, SP, Brazil, from 2005 to 2007. Food intake was assessed by three 24-hour recalls of 640 participants, both genders, aged 30 to 88 years old. Eighteen new food groups were proposed according to their quantity and quality of fat, carbohydrates, sodium, and fiber. The new food groups incorporate recent evidences of the association between diet and the risk of developing type 2 diabetes.

  18. Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria

    OpenAIRE

    Wu, En?Tzu; Nien, Feng?Jung; Kuo, Chun?Heng; Chen, Szu?Chi; Chen, Kuan?Yu; Chuang, Lee?Ming; Li, Hung?Yuan; Lee, Chien?Nan

    2015-01-01

    Abstract Aims/Introduction The International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes are associated with increased prevalence. However, it remains unknown if intervention for more women with gestational diabetes mellitus by the IADPSG criteria results in better pregnancy outcomes than adopting the Carpenter and Coustan (C&C) criteria in Asian populations. Materials and Methods This was a retrospective cohort study. A total of 1,840 wome...

  19. College students with diabetes: using focus groups and interviews to determine psychosocial issues and barriers to control.

    Science.gov (United States)

    Wdowik, M J; Kendall, P A; Harris, M A

    1997-01-01

    College students with diabetes are at risk for improvised diabetes care due to their age, newly acquired independence, and erratic schedules. The purpose of this study was to employ focus groups and interviews to identity factors that affect the ability of these students to engage in appropriate self-care behaviors. Focus group and interview questions were developed to address variables of the Expanded Health Belief Model. Two focus groups and fifteen interviews were conducted. Barriers to successful diabetes management were time management, stress hypoglycemic reactions, diet management constraints, and inadequate finances. Several psychosocial issues that affected successful management also were identified. These issues were grouped into three categories: (1) inconveniences of diabetes management, (2) motivators to managing diabetes, and (3) social support issues. The findings show the value of formative evaluation that can then be used to design diabetes education programs to meet clients' perceived needs.

  20. Culturally appropriate health education for type 2 diabetes mellitus in ethnic minority groups.

    Science.gov (United States)

    Hawthorne, Kamila; Robles, Yolanda; Cannings-John, Rebecca; Edwards, Adrian Gk

    2008-07-16

    Ethnic minority groups in upper-middle and high income countries tend to be socio-economically disadvantaged and to have higher prevalence of type 2 diabetes than the majority population. To assess the effectiveness of culturally appropriate diabetes health education on important outcome measures in type 2 diabetes. We searched the The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, SIGLE and reference lists of articles. We also contacted authors in the field and handsearched commonly encountered journals. RCTs of culturally appropriate diabetes health education for people over 16 years with type 2 diabetes mellitus from named ethnic minority groups resident in upper-middle or high income countries. Two authors independently assessed trial quality and extracted data. Where there were disagreements in selection of papers for inclusion, all four authors discussed the studies. We contacted study authors for additional information when data appeared to be missing or needed clarification. Eleven trials involving 1603 people were included, with ten trials providing suitable data for entry into meta-analysis. Glycaemic control (HbA1c), showed an improvement following culturally appropriate health education at three months (weight mean difference (WMD) - 0.3%, 95% CI -0.6 to -0.01), and at six months (WMD -0.6%, 95% CI -0.9 to -0.4), compared with control groups who received 'usual care'. This effect was not significant at 12 months post intervention (WMD -0.1%, 95% CI -0.4 to 0.2). Knowledge scores also improved in the intervention groups at three months (standardised mean difference (SMD) 0.6, 95% CI 0.4 to 0.7), six months (SMD 0.5, 95% CI 0.3 to 0.7) and twelve months (SMD 0.4, 95% CI 0.1 to 0.6) post intervention. Other outcome measures both clinical (such as lipid levels, and blood pressure) and patient centred (quality of life measures, attitude scores and measures of patient empowerment and self-efficacy) showed no significant improvement compared with

  1. Reduced CGP12177 binding to cardiac {beta}-adrenoceptors in hyperglycemic high-fat-diet-fed, streptozotocin-induced diabetic rats

    Energy Technology Data Exchange (ETDEWEB)

    Thackeray, James T.; Parsa-Nezhad, Maryam; Kenk, Miran; Thorn, Stephanie L. [Molecular Function and Imaging Program, National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y4W7 (Canada); Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, Ottawa, Ontario, K1H8M5 (Canada); Kolajova, Maria [Molecular Function and Imaging Program, National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y4W7 (Canada); Beanlands, Rob S.B. [Molecular Function and Imaging Program, National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y4W7 (Canada); Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, Ottawa, Ontario, K1H8M5 (Canada); DaSilva, Jean N., E-mail: jdasilva@ottawaheart.ca [Molecular Function and Imaging Program, National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y4W7 (Canada); Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, Ottawa, Ontario, K1H8M5 (Canada)

    2011-10-15

    Introduction: Abnormal sympathetic nervous system and {beta}-adrenoceptor ({beta}-AR) signaling is associated with diabetes. [{sup 3}H]CGP12177 is a nonselective {beta}-AR antagonist that can be labeled with carbon-11 for positron emission tomography. The aim of this study was to examine the suitability of this tracer for evaluation of altered {beta}-AR expression in diabetic rat hearts. Methods: Ex vivo biodistribution with [{sup 3}H]CGP12177 was carried out in normal Sprague-Dawley rats for evaluation of specific binding and response to continuous {beta}-AR stimulation by isoproterenol. In a separate group, high-fat-diet feeding imparted insulin resistance and a single intraperitoneal injection of streptozotocin (STZ) or vehicle evoked hyperglycemia (blood glucose >11 mM). [{sup 3}H]CGP12177 biodistribution was assessed at 2 and 8 weeks post-STZ to measure {beta}-AR binding in heart, 30 min following tracer injection. Western blotting of {beta}-AR subtypes was completed in parallel. Results: Infusion of isoproterenol over 14 days did not affect cardiac binding of [{sup 3}H]CGP12177. Approximately half of rats treated with STZ exhibited sustained hyperglycemia and progressive hypoinsulinemia. Myocardial [{sup 3}H]CGP12177 specific binding was unchanged at 2 weeks post-STZ but significantly reduced by 30%-40% at 8 weeks in hyperglycemic but not euglycemic STZ-treated rats compared with vehicle-treated controls. Western blots supported a significant decrease in {beta}{sub 1}-AR in hyperglycemic rats. Conclusions: Reduced cardiac [{sup 3}H]CGP12177 specific binding in the presence of sustained hyperglycemia corresponds to a decrease in relative {beta}{sub 1}-AR expression. These data indirectly support the use of [{sup 11}C]CGP12177 for assessment of cardiac dysfunction in diabetes.

  2. An epidemiological study of diabetes mellitus amongst high risk age group population in urban and Rural areas of kanpur

    Directory of Open Access Journals (Sweden)

    Nadeem Ahmad

    2003-12-01

    Full Text Available Research Question : - What is the magnitude of Diabetes mellitus in the urban and rural areas of Kanpur.Objectives:To study the prevalence of diabetes mellitus amongst high risk age group population in urban and rural areas of Kanpur.To compare the magnitude of problem of diabetes mellitus between urban and rural areas of Kanpur.To study the possible associates and socio-demographic variables related to diabetes mellitus.Study Design : Cross sectional study.Setting : The study was performed on three thousand population each in urban and rural areas of Kanpur.Participants : High risk age group population i.e. 45 years and above.Study variables : Age, Sex. impaired glucose tolerance. Body mass index, Education, Working status. Social class, family history of diabetes.Statistical analysis : Chi-square lest, percentagesResults From a total of 676 persons of high risk age group i.e. 45 years and above, the overall prevalence of diabetes mellitus in the study areas was observed lobe 7. l%with 9.94% in urban and 3.61% in rural areas, the maximum percetage of diabetes cases (41.66% was in the age group of 56-60 years. Higher prevalence of diabetes was observed in the obese (56.25% and sedentary (87.5% persons. The family history' of diabetes mellitus was present in (35.41% of diabetes mellitus cases.

  3. 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

  4. Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot

    NARCIS (Netherlands)

    Schaper, N. C.; Andros, G.; Apelqvist, J.; Bakker, K.; Lammer, J.; Lepantalo, M.; Mills, J. L.; Reekers, J.; Shearman, C. P.; Zierler, R. E.; Hinchliffe, R. J.

    2012-01-01

    The International Working Group on the Diabetic Foot (IWDGF) has produced in 2011 a guideline on the diagnosis and treatment of peripheral arterial disease in patients with diabetes and a foot ulcer. This document, together with a systematic review that provided the background information on

  5. Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes : the Hvidoere Study Group on Childhood Diabetes

    NARCIS (Netherlands)

    Aman, J.; Skinner, T. C.; de Beaufort, C. E.; Swift, P. G. F.; Aanstoot, H-J; Cameron, F.

    angstrom man J, Skinner TC, de Beaufort CE, Swift PGF, Aanstoot H-J, Cameron F, for and on behalf of the Hvidoere Study Group on Childhood Diabetes. Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere

  6. Diabetic Retinopathy

    Science.gov (United States)

    ... Disease > Facts About Diabetic Eye Disease Facts About Diabetic Eye Disease Points to Remember Diabetic eye disease ... existing therapies for different patient groups. What is diabetic eye disease? Diabetic eye disease can affect many ...

  7. Does glimepiride alter the pharmacokinetics of sildenafil citrate in diabetic nephropathy animals: investigating mechanism of interaction by molecular modeling studies.

    Science.gov (United States)

    Tripathi, Alok Shiomurti; Timiri, Ajay Kumar; Mazumder, Papiya Mitra; Chandewar, Anil

    2015-10-01

    The present study evaluates possible drug interactions between glimepiride (GLIM) and sildenafil citrate (SIL) in streptozotocin (STZ)-induced diabetic nephropathic (DN) animals and also postulates the possible mechanism of interaction based on molecular modeling studies. Diabetic nephropathy was induced by single dose of STZ (60 mg kg(-1), i.p.) and was confirmed by assessing blood and urine biochemical parameters 28 days after induction. Selected DN animals were used to explore the drug interaction between GLIM (0.5 mg kg(-1), p.o.) and SIL (2.5 mg kg(-1), p.o.) on the 29th and 70th day of the protocol. Possible drug interaction was assessed by evaluating the plasma drug concentration using HPLC-UV and changes in biochemical parameters in blood and urine were also determined. The mechanism of the interaction was postulated from the results of a molecular modeling study using the Maestro module of Schrodinger software. DN was confirmed as there was significant alteration in blood and urine biochemical parameters in STZ-treated groups. The concentration of SIL increased significantly (P Molecular modeling revealed important interactions with rat serum albumin and CYP2C9. GLIM has a strong hydrophobic interaction with binding site residues of rat serum albumin compared to SIL, whereas for CYP2C9, GLIM forms a stronger hydrogen bond than SIL with polar contacts and hydrophobic interactions. The present study concludes that bioavailability of SIL increases when co-administered chronically with GLIM in the management of DN animals, and the mechanism is supported by molecular modeling studies.

  8. Gender differences across racial and ethnic groups in the quality of care for diabetes.

    Science.gov (United States)

    Correa-de-Araujo, Rosaly; McDermott, Kelly; Moy, Ernest

    2006-01-01

    High-quality care for diabetes is based on proper prevention, coordination of care among a multidisciplinary team of health care professionals, enhanced patient-provider relationships, and patient self-management skills. This paper discusses gender differences across racial and ethnic groups in the quality of care for type 2 diabetes according to 10 measures defined by the National Healthcare Quality Report and the National Healthcare Disparities Report. These measures include 5 process measures and one composite measure derived from the Medical Expenditure Panel Survey and 4 outcome measures derived from the Healthcare Cost and Utilization Project. National rates for 2 process measures--measurement of HbA1c (women 89.70% versus men 90.10%) and lipid profile (women 92.9% versus men 95.3%)--are high, but only 28.9% of women and 33.9% of men with diabetes received all 5 recommended process measures (HbA1c, lipid profile, eye exam, foot exam, and influenza immunization). Screening rates for retinal and foot exams and influenza immunization should be improved for all, but the need is particularly urgent for Hispanics and non-Hispanic blacks. Women and men have similar rates of hospital admissions for uncontrolled diabetes, but rates for lower extremity amputations were higher for men, particularly non-Hispanic blacks and Hispanics. Avoidable hospitalizations for diabetes decreased as income increased across racial/ethnic groups, but other factors (e.g., quality of primary care, age, relationship with providers, patients' self-management skills) may influence such rates. Moreover, any improvements in the diabetes outcomes measures may lag many years behind any measurable improvements in quality of care. Well-designed interventions that reallocate resources for diabetes self-care should be developed to ensure that gender differences are addressed across racial/ethnic groups. Because much of this care involves the management of risk factors, self-management education

  9. Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians

    Directory of Open Access Journals (Sweden)

    Diep Lien M

    2011-07-01

    Full Text Available Abstract Background The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians. Methods Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4% participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used. Results Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p Conclusions Ethnic differences in the prevalence of CVD were prominent for individuals without diabetes. Primary CVD prevention including identification of undiagnosed diabetes should be prioritized for ethnic minorities without known diabetes.

  10. Diagnosis and potential management of gestational diabetes mellitus using the International association of diabetes and pregnancy study groups criteria.

    Science.gov (United States)

    Fukatsu, Mayumi; Takai, Yasushi; Matsunaga, Shigetaka; Era, Sumiko; Ono, Yoshihisa; Saito, Masahiro; Baba, Kazunori; Seki, Hiroyuki

    2017-02-01

    Appropriate screening and plasma glucose control is important during pregnancy, but an international consensus has not been reached regarding the recommended method of screening and diagnosis of gestational diabetes mellitus (GDM). We investigated glucose intolerance in pregnant women diagnosed with GDM, applying stricter screening criteria. The study involved 452 women with singleton pregnancies, who underwent a 2 h 75 g oral glucose tolerance test between January 2006 and December 2010. They had previously been screened for GDM using Japan Society of Obstetrics and Gynecology (JSOG) criteria. We retrospectively re-evaluated their status using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. The major differences between JSOG and IADPSG criteria are the number of applicable threshold values, and the threshold value for fasting glucose measured by the glucose tolerance test. The insulinogenic index and insulin resistance according to the homeostasis model assessment were compared among groups in the presence or absence of obesity. GDM was diagnosed in 56 (1.07%) and 133 (2.54%) women based on the JSOG and IADPSG criteria, respectively. Compared to non-GDM, non-obese women, those diagnosed with GDM according to IADPSG criteria had significantly higher insulin resistance, while those diagnosed with GDM exceeding two or more threshold values had significantly lower insulinogenic indexes. Adopting stricter diagnostic criteria increased the prevalence of GDM 2.37-fold, as women previously diagnosed with milder abnormalities in glucose levels were then diagnosed as having GDM. © 2016 Japan Society of Obstetrics and Gynecology.

  11. DNA polymorphism analysis of candidate genes for type 2 diabetes mellitus in a Mexican ethnic group.

    Science.gov (United States)

    Flores-Martínez, S E; Islas-Andrade, S; Machorro-Lazo, M V; Revilla, M C; Juárez, R E; Mújica-López, K I; Morán-Moguel, M C; López-Cardona, M G; Sánchez-Corona, J

    2004-01-01

    Type 2 diabetes mellitus is a complex metabolic disorder resulting from the action and interaction of many genetic and environmental factors. It has been reported that polymorphisms in genes involved in the metabolism of glucose are associated with the susceptibility to develop type 2 diabetes mellitus. Although the risk of developing type 2 diabetes mellitus increases with age, as well as with obesity and hypertension, its prevalence and incidence are different among geographical regions and ethnic groups. In Mexico, a higher prevalence and incidence has been described in the south of the country, and differences between urban and rural communities have been observed. We studied 73 individuals from Santiago Jamiltepec, a small indigenous community from Oaxaca State, Mexico. This population has shown a high prevalence of type 2 diabetes mellitus, and the aim of this study was to analyze the relationship between the Pst I (insulin gene), Nsi I (insulin receptor gene) and Gly972Arg (insulin receptor substrate 1 gene) polymorphisms and type 2 diabetes mellitus, obesity and hypertension in this population. Clinical evaluation consisted of BMI and blood pressure measurements, and biochemical assays consisted of determination of fasting plasma insulin and glucose levels. PCR and restriction enzyme digestion analysis were applied to genomic DNA to identify the three polymorphisms. From statistical analysis carried out here, individually, the Pst I, Nsi I and Gly972Arg polymorphisms were not associated with the type 2 diabetes, obese or hypertensive phenotypes in this population. Nevertheless, there was an association between the Nsi I and Pst I polymorphisms and increased serum insulin levels.

  12. The Mela Study: exploring barriers to diabetes research in black and minority ethnic groups.

    Science.gov (United States)

    Hood, Gillian A; Chowdhury, Tahseen A; Griffiths, Christopher J; Hood, Rosie K E; Mathews, Christopher; Hitman, Graham A

    2015-01-01

    Black and minority ethnic (BME) groups are particularly susceptible to diabetes and its vascular complications in the United Kingdom and most western societies. To understand potential predisposition and tailor treatments accordingly, there is a real need to engage these groups in diabetes research. Despite this, BME participation in research studies continues to remain low in most countries and this may be a contributory factor to reduced health outcomes and poorer quality of life in these groups. This study explores the barriers BME groups may have towards participation in diabetes research in one area of East London, and includes local recommendations on how to improve this for the future. A questionnaire designed from previously reported exploratory work and piloted in several BME localities was distributed at the East London Bangladeshi Mela and similar cultural and religious events in London, UK. People were asked opportunistically to complete the survey themselves if they understood English, or discuss their responses with an advocate. The purpose of the questionnaire was to understand current local awareness with regards to diabetes, identify specific BME barriers and attitudes towards diabetes research by ethnicity, gender and age, and gain insight into how these barriers may be addressed. Of 1682 people surveyed (16-90 years; median age 40 years), 36.4% were South Asian, 25.9% White, and 11.1% Black and other ethnicities; 26.6% withheld their ethnicity. Over half cited language problems generally (54%) and lack of research awareness (56%) as main barriers to engaging in research. South Asian groups were more likely to cite research as too time consuming (42%) whereas Black groups were more concerned with potential drug side effects in research (39%). Participants expressed a general mistrust of research, and the need for researchers to be honest in their approach. Recommendations for increased participation in South Asian groups centred round both helping

  13. Group participants' experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

    2017-01-01

    The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants' experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of these programs. Semi-structured interviews were conducted with all individuals who participated in the intervention. Using thematic analysis underpinned by self-determination theory, we developed themes that explored participants' motivators in relation to diabetes management and the impact of group interactions on their experiences and motivation. The key themes included knowledge, experience, group interactions and motivation. Participants perceived that the group interactions facilitated further learning and increased motivation, achieved through normalization, peer identification or by talking with, and learning from the experience of others. The results support the use of patient-centred programs that prioritize group interactions over the didactic presentation of content, which may address relevant psychological needs of people diagnosed with type 2 diabetes mellitus, and improve their motivation and health behaviours. Future group-based education programs may benefit from the use of self-determination theory as a framework for intervention design to enhance participant motivation.

  14. Association between quality management and performance indicators in Dutch diabetes care groups : A cross-sectional study

    NARCIS (Netherlands)

    Campmans-Kuijpers, Marjo J E; Baan, Caroline A.; Lemmens, Lidwien C.; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M|info:eu-repo/dai/nl/074622781

    2015-01-01

    Objectives: To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices.

  15. Prevalence of eye pathology in a group of diabetic patients at National District Hospital Outpatient Department in Bloemfontein, South Africa

    Directory of Open Access Journals (Sweden)

    Joleen P. Cairncross

    2017-01-01

    Full Text Available Background: Diabetic retinopathy is the third most common cause of blindness after cataracts and glaucoma in South Africa. Primary healthcare interventions providing eye care services play an important role in preventing complications.Aim: To determine the prevalence of eye pathology in a group of diabetic patients at National District Hospital by screening for diabetes-associated ocular pathology.Setting: Outpatients Department run by Department of Family Medicine at National District Hospital in Bloemfontein from June to July 2014.Methods: Interviews were used to collect information regarding diabetic patients’ history of diabetes mellitus and if and when previous diabetic retinopathy screening was performed. Visual acuity was assessed, intra-ocular pressure measured and a non-mydriatic digital fundus camera used to screen for retinal pathology.Results: During the last year, only 4.5% of patients had their vision checked with a Snellen chart, and 16.5% were examined with an ophthalmoscope. Since diagnosis of diabetes, only 15.5% of patients were referred to an ophthalmologist. Patient referral was needed for 87 (42.9% cases for refractive disorders, 37 (18.2% for suspected glaucoma, 30 (14.8% for cataracts, and 22 (10.8% for diabetic retinopathy.Conclusion: This study confirms that glaucoma, cataracts and diabetic retinopathy are prevalent eye conditions among diabetic patients. Offering eye screening at primary healthcare level may contribute to early detection of eye pathology and timeous referral for sight-saving treatment.

  16. Impaired noradrenaline homeostasis in rats with painful diabetic neuropathy as a target of duloxetine analgesia.

    Science.gov (United States)

    Kinoshita, Jun; Takahashi, Yukari; Watabe, Ayako M; Utsunomiya, Kazunori; Kato, Fusao

    2013-11-27

    Painful diabetic neuropathy (PDN) is a serious complication of diabetes mellitus that affects a large number of patients in many countries. The molecular mechanisms underlying the exaggerated nociception in PDN have not been established. Recently, duloxetine (DLX), a serotonin and noradrenaline re-uptake inhibitor, has been recommended as one of the first-line treatments of PDN in the United States Food and Drug Administration, the European Medicines Agency and the Japanese Guideline for the Pharmacologic Management of Neuropathic pain. Because selective serotonin re-uptake inhibitors show limited analgesic effects in PDN, we examined whether the potent analgesic effect of DLX contributes toward improving the pathologically aberrant noradrenaline homeostasis in diabetic models. In streptozotocin (STZ) (50 mg/kg, i.v.)-induced diabetic rats that exhibited robust mechanical allodynia and thermal hyperalgesia, DLX (10 mg/kg, i.p.) significantly and markedly increased the nociceptive threshold. The analgesic effect of DLX was nullified by the prior administration of N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) (50 mg/kg, i.p.), which drastically eliminated dopamine-beta-hydroxylase- and norepinephrine transporter-immunopositive fibers in the lumbar spinal dorsal horn and significantly reduced the noradrenaline content in the lumbar spinal cord. The treatment with DSP-4 alone markedly lowered the nociceptive threshold in vehicle-treated non-diabetic rats; however, this pro-nociceptive effect was occluded in STZ-treated diabetic rats. Furthermore, STZ-treated rats exhibited a higher amount of dopamine-beta-hydroxylase- and norepinephrine transporter-immunopositive fibers in the dorsal horn and noradrenaline content in the spinal cord compared to vehicle-treated rats. Impaired noradrenaline-mediated regulation of the spinal nociceptive network might underlie exaggerated nociception in PDN. DLX might exert its analgesic effect by selective enhancement of

  17. OPERATIVE GROUP: EDUCATIONAL PRACTICE AS AN EXPRESSION FOR SELF-CARE IN DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    Mariana Almeida Maia

    2013-12-01

    Full Text Available The goal is to understand the views of users with type 2 diabetes about their participation in the operating groups and the impact of self-care practices. This is a qualitative descriptive- exploratory held in three basic health units of the sanitary district east of Belo Horizonte and involved the participation of 18 users in 2011. The speeches of the users were analyzed based on content analysis, identifying the categories: exchange of experience, education for self- care, assessment of user participation in the operative groups, Feelings and links between professionals and users. It was noted that the operational groups provided the construction of knowledge through listening, reflection and questioning of reality where the user identified the importance of knowledge about diet, physical activity and treatment. We found that health actions implemented through the operational groups encourage users to think about your lifestyle, characterized as a tool in health education from the perspective of promotion, prevention and control.

  18. Impact of maternal nativity on the prevalence of diabetes during pregnancy among U.S. ethnic groups.

    Science.gov (United States)

    Kieffer, E C; Martin, J A; Herman, W H

    1999-05-01

    This study examines the impact of maternal nativity (birthplace) on the overall prevalence of diabetes during pregnancy and among 15 racial and ethnic groups in the U.S. Birth certificate data for all resident single live births in the U.S. from 1994 to 1996 were used to calculate reported diabetes prevalence during pregnancy and to assess the impact of maternal birthplace outside of the 50 states and Washington, DC, on the risk of diabetes before and after adjustment for differences in maternal age, other sociodemographic characteristics, and late or no initiation of prenatal care overall and for each racial and ethnic group. Mothers born outside of the U.S. are significantly more likely to have diabetes during pregnancy. The impact of maternal nativity on diabetes prevalence is largely explained by the older childbearing age of immigrant mothers. However, adjusted diabetes risk remains elevated for Asian-Indian, non-Hispanic black, Filipino, Puerto Rican, and Central and South American mothers who were born outside the U.S. Conversely, birthplace outside the U.S. significantly reduces diabetes risk for Japanese, Mexican, and Native American women. Identification, treatment, and follow-up of immigrant mothers with diabetes during pregnancy may require special attention to language and sociocultural barriers to effective care. Systematic surveillance of the prevalence and impact of diabetes during pregnancy for immigrant and nonimmigrant women, particularly in racial and ethnic minority groups, and more detailed studies on the impact of acculturation on diabetes may increase understanding of the epidemiology of diabetes during pregnancy in our increasingly diverse society.

  19. Non-Obese Diabetic Mice Rapidly Develop Dramatic Sympathetic Neuritic Dystrophy

    Science.gov (United States)

    Schmidt, Robert E.; Dorsey, Denise A.; Beaudet, Lucie N.; Frederick, Kathy E.; Parvin, Curtis A.; Plurad, Santiago B.; Levisetti, Matteo G.

    2003-01-01

    To address the pathogenesis of diabetic autonomic neuropathy, we have examined the sympathetic nervous system in non-obese diabetic (NOD) and streptozotocin (STZ)-induced diabetic mice, two models of type 1 diabetes, and the db/db mouse, a model of type 2 diabetes. After only 3 to 5 weeks of diabetes, NOD mice developed markedly swollen axons and dendrites (“neuritic dystrophy”) in the prevertebral superior mesenteric and celiac ganglia (SMG-CG), similar to the pathology described in diabetic STZ- and BBW-rat and man. Comparable changes failed to develop in the superior cervical ganglia of the NOD mouse or in the SMG-CG of non-diabetic NOD siblings. STZ-induced diabetic mice develop identical changes, although at a much slower pace and to a lesser degree than NOD mice. NOD-SCID mice, which are genetically identical to NOD mice except for the absence of T and B cells, do not develop diabetes or neuropathology comparable to diabetic NOD mice. However, STZ-treated NOD-SCID mice develop severe neuritic dystrophy, evidence against an exclusively autoimmune pathogenesis for autonomic neuropathy in this model. Chronically diabetic type 2 db/db mice fail to develop neuritic dystrophy, suggesting that hyperglycemia alone may not be the critical and sufficient element. The NOD mouse appears to be a valuable model of diabetic sympathetic autonomic neuropathy with unambiguous, rapidly developing neuropathology which corresponds closely to the characteristic pathology of other rodent models and man. PMID:14578206

  20. Group Patient Education: Effectiveness of a Brief Intervention in People with Type 2 Diabetes Mellitus in Primary Health Care in Greece: A Clinically Controlled Trial

    Science.gov (United States)

    Merakou, K.; Knithaki, A.; Karageorgos, G.; Theodoridis, D.; Barbouni, A.

    2015-01-01

    This study aims to assess the impact of a brief patient group education intervention in people with type 2 diabetes mellitus. The sample, 193 people with type 2 diabetes mellitus who were patients at the diabetic clinic of a primary health care setting in Attica, was assigned to two groups, intervention (138 individuals) and control group (55…

  1. Continuous glucose monitoring system and new era of early diagnosis of diabetes in high risk groups

    Directory of Open Access Journals (Sweden)

    Ashraf Soliman

    2014-01-01

    Full Text Available Continuous glucose monitoring (CGM systems are an emerging technology that allows frequent glucose measurements to monitor glucose trends in real time. Their use as a diagnostic tool is still developing and appears to be promising. Combining intermittent glucose self-monitoring (SGM and CGM combines the benefits of both. Significant improvement in the treatment modalities that may prevent the progress of prediabetes to diabetes have been achieved recently and dictates screening of high risk patients for early diagnosis and management of glycemic abnormalities. The use of CGMS in the diagnosis of early dysglycemia (prediabetes especially in high risk patients appears to be an attractive approach. In this review we searched the literature to investigate the value of using CGMS as a diagnostic tool compared to other known tools, namely oral glucose tolerance test (OGTT and measurement of glycated hemoglobin (HbA1C in high risk groups. Those categories of patients include adolescents and adults with obesity especially those with family history of type 2 diabetes mellitus, polycystic ovary syndrome (PCO, gestational diabetes, cystic fibrosis, thalassemia major, acute coronary syndrome (ACS, and after renal transplantation. It appears that the ability of the CGMS for frequently monitoring (every 5 min glucose changes during real-life settings for 3 to 5 days stretches the chance to detect more glycemic abnormalities during basal and postprandial conditions compared to other short-timed methods.

  2. Effects of Group Training on Depression and Anxiety among Patients with Type I Diabetes: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shanaz Rostami

    2016-05-01

    Full Text Available Background Depression and anxiety can have a significant impact on prognosis in diabetic patients. In this study we evaluate how the effect of group learning on anxiety and depression in adolescents with type 1 diabetes at clinics of Ahvaz Jundishapur University of Medical Science. Materials and Methods  This study was carried out via a pretest- posttest design on the adolescent 11-21 ages with type I diabetes. 74 patients were randomized in education group (n=37 either to the control group (n=37. Data collection tools included demographic and clinical status questionnaires, and the Beck anxiety and depression inventory. Group training intervention was done for intervention group and three months after study two groups filled questionnaires and inventories. Data analyzed using chi-square test and t-test using SPSS- 22 software. Results  Findings showed that there was a significant difference between patients mean of depression in intervention group before and after intervention (P

  3. High-Mobility Group Box-1 Induces Decreased Brain-Derived Neurotrophic Factor-Mediated Neuroprotection in the Diabetic Retina

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    Ahmed M. Abu El-Asrar

    2013-01-01

    Full Text Available To test the hypothesis that brain-derived neurotrophic factor-(BDNF- mediated neuroprotection is reduced by high-mobility group box-1 (HMGB1 in diabetic retina, paired vitreous and serum samples from 46 proliferative diabetic retinopathy and 34 nondiabetic patients were assayed for BDNF, HMGB1, soluble receptor for advanced glycation end products (sRAGE, soluble intercellular adhesion molecule-1 (sICAM-1, monocyte chemoattractant protein-1 (MCP-1, and TBARS. We also examined retinas of diabetic and HMGB1 intravitreally injected rats. The effect of the HMGB1 inhibitor glycyrrhizin on diabetes-induced changes in retinal BDNF expressions was studied. Western blot, ELISA, and TBARS assays were used. BDNF was not detected in vitreous samples. BDNF levels were significantly lower in serum samples from diabetic patients compared with nondiabetics, whereas HMGB1, sRAGE, sICAM-1, and TBARS levels were significantly higher in diabetic serum samples. MCP-1 levels did not differ significantly. There was significant inverse correlation between serum levels of BDNF and HMGB1. Diabetes and intravitreal administration of HMGB1 induced significant upregulation of the expression of HMGB1, TBARS, and cleaved caspase-3, whereas the expression of BDNF and synaptophysin was significantly downregulated in rat retinas. Glycyrrhizin significantly attenuated diabetes-induced downregulation of BDNF. Our results suggest that HMGB1-induced downregulation of BDNF might be involved in pathogenesis of diabetic retinal neurodegeneration.

  4. [Retropharyngeal phlegmon caused by a group B Streptococcus in a diabetic patient: report of one case].

    Science.gov (United States)

    Sapunar Z, Jorge; Cabello V, Alvaro; Godoy R, Emilio

    2008-03-01

    We report a 47 year-old diabetic male, admitted due to metabolic decompensation, malaise, purulent pharyngeal discharge and a mass in the posterior cervical region. Blood glucose was 270 mg/dl, a nasopharyngoscopy showed a pharyngeal phlegmon and CT scan confirmed the presence of a phlegmon in the retropharyngeal region. He was treated with sodium penicillin, cloxacillin and ceftriazone and the phlegmon was drained surgically. The culture of the purulent discharge gave growth to a Group B Streptococcus. The evolution was favorable and the patient completed seven days with intravenous antimicrobials and additional seven days with oral ampicillin/sulbactam.

  5. Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?

    DEFF Research Database (Denmark)

    Due-Christensen, Mette; Zoffmann, Vibeke; Hommel, Eva

    2012-01-01

    and depression subscale), well-being (World Health Organization 5) and HbA1c. Results Equal numbers of patients with HbA1c above and below 64 mmol/mol (8%) joined the support groups (n = 54). Focus group interviews revealed that major benefits were feeling less alone and being intuitively understood among peers....... The patients perceived the support groups as a safe environment for sharing experiences. Problem Areas in Diabetes, Global Severity Index and depression subscale scores were significantly reduced post-intervention and maintained at 1-year follow-up. Well-being increased insignificantly. HbA1c was unchanged...... glycaemic control might have an unacknowledged psychosocial burden of living with the illness....

  6. Diabetes Prevalence Among Racial-Ethnic Minority Group Members With Severe Mental Illness Taking Antipsychotics: Double Jeopardy?

    Science.gov (United States)

    Mangurian, Christina; Keenan, Walker; Newcomer, John W; Vittinghoff, Eric; Creasman, Jennifer M; Schillinger, Dean

    2017-08-01

    This study assessed differences in diabetes prevalence based on race-ethnicity among people with severe mental illnesses. This retrospective cohort study examined diabetes prevalence in 2009 among California Medicaid enrollees with severe mental illness who were screened for diabetes (N=19,364). Poisson regression assessed differences in diabetes prevalence by race-ethnicity. The sample was standardized to the U.S. The overall prevalence of diabetes was 32.0%. The adjusted prevalence for all minority groups with severe mental illness, except for Asians, was significantly higher than for whites (1.21-1.28 adjusted prevalence ratios). With inverse probability weighting to reduce selection bias captured by measured factors, estimated prevalence of diabetes among screened participants was 27.3%. The prevalence of diabetes in minority groups with severe mental illness was significantly higher than among whites with severe mental illness. Mental health administrators should implement universal diabetes screening with specific outreach efforts targeting minority populations with severe mental illness.

  7. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group

    NARCIS (Netherlands)

    Geerlings, S. E.; Stolk, R. P.; Camps, M. J.; Netten, P. M.; Hoekstra, J. B.; Bouter, K. P.; Bravenboer, B.; Collet, J. T.; Jansz, A. R.; Hoepelman, A. I.

    2000-01-01

    OBJECTIVE: To study the prevalence of and risk factors for asymptomatic bacteriuria (ASB) in women with and without diabetes. RESEARCH DESIGN AND METHODS: A total of 636 nonpregnant women with diabetes (type 1 and type 2) who were 18-75 years of age and had no abnormalities of the urinary tract, and

  8. Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Steinsbekk Aslak

    2012-07-01

    Full Text Available Abstract Background Diabetes self-management education (DSME can be delivered in many forms. Group based DSME is widespread due to being a cheaper method and the added advantages of having patient meet and discuss with each other. assess effects of group-based DSME compared to routine treatment on clinical, lifestyle and psychosocial outcomes in type-2 diabetes patients. Methods A systematic review with meta-analysis. Computerised bibliographic database were searched up to January 2008 for randomised controlled trials evaluating group-based DSME for adult type-2 diabetics versus routine treatment where the intervention had at least one session and =/>6 months follow-up. At least two reviewers independently extracted data and assessed study quality. Results In total 21 studies (26 publications, 2833 participants were included. Of all the participants 4 out of 10 were male, baseline age was 60 years, BMI 31.6, HbA1c 8.23%, diabetes duration 8 years and 82% used medication. For the main clinical outcomes, HbA1c was significantly reduced at 6 months (0.44% points; P = 0.0006, 13 studies, 1883 participants, 12 months (0.46% points; P = 0.001, 11 studies, 1503 participants and 2 years (0.87% points; P  Conclusions Group-based DSME in people with type 2 diabetes results in improvements in clinical, lifestyle and psychosocial outcomes.

  9. Problemática laboral en un grupo de personas con diabetes mellitus Working problems related to a group of persons with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Rosario García González

    2009-12-01

    información a los administradores y orientaciones prácticas a las personas con diabetes mellitus podría disminuir los problemas afrontados.INTRODUCTION: diabetes mellitus can affect working activities as well as different aspects of working activities can difficult the accomplishment of diabetes treatment requirements. Nevertheless there are not enough papers on the matter and the purpose of this study was to identify possible difficulties affronting by a group of people with diabetes to develop working activities. OBJETIVES: to determine the frequency of working difficulties acknowledged by the group, to characterize difficulties found, and to identify opinions on the relationship between diabetes and working activities. METHODS: the universe was formed by patients admitted in the daily service of Diabetes Care Center from september to december of 2006 and the sample has included those incorporated to working activities at the moment and those retired in 2005. Surveys and group discussions were used for collecting information. Quantitative data were processed using descriptive statistics, and data of group discussions were processed using the inductive exploratory qualitative method. RESULTS: 25 % of workers and 35 % of retired have recognized some interference between diabetes and working activities. The problems identified were difficulties to accomplish foot requirements (75 %, extension of working day (21.6 %, physical efforts (42.2 % and a lack of information from managers to understand diabetes situation. All retired people recognized the diabetes mellitus as cause of their decision to have recourse to working retirement. CONCLUSIONS: problems to face the working life was present in workers and retired people. The major problems identified included alimentary requirements, physical efforts, and the extension of working days. The group studied has considered that more information to managers and practical guidance for people with diabetes mellitus could decrease

  10. Reduced frequency of blood group Lewis a-b- in female Type 1 diabetes patients

    DEFF Research Database (Denmark)

    Kharagjitsingh, A.V.; Prinsen, K.; Lemkes, H.H.

    2008-01-01

    AIMS: To examine a disputed association between the Lewis(a(-)b(-)) phenotype and Type 1 diabetes (T1D). METHODS: Lewis red blood cell phenotyping was performed for 97 T1D White patients and 100 control subjects using monoclonal antibodies. Two historical cohorts were also included as a control...... population. RESULTS: T1D patients had a lower frequency (4.1%) of Lewis(a(-)b(-)) blood group compared with simultaneously tested healthy control subjects (10.0%) and the historical control group (11.1%, P = 0.02). Male T1D patients showed a Lewis(a(-)b(-)) frequency of 8.0%, which was similar to both...

  11. Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria.

    Science.gov (United States)

    Wu, En-Tzu; Nien, Feng-Jung; Kuo, Chun-Heng; Chen, Szu-Chi; Chen, Kuan-Yu; Chuang, Lee-Ming; Li, Hung-Yuan; Lee, Chien-Nan

    2016-01-01

    The International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria for gestational diabetes are associated with increased prevalence. However, it remains unknown if intervention for more women with gestational diabetes mellitus by the IADPSG criteria results in better pregnancy outcomes than adopting the Carpenter and Coustan (C&C) criteria in Asian populations. This was a retrospective cohort study. A total of 1,840 women, 952 subjects by the IADPSG criteria and 888 subjects by the C&C criteria, who delivered singletons in 2011 in a single tertiary center, were included in the study. The same therapeutic interventions were offered to women with gestational diabetes mellitus by the two criteria. Maternal and neonatal outcomes were evaluated. Adopting the IADPSG criteria increased the prevalence of gestational diabetes mellitus diagnosis to 13.44%, compared with 2.59% by the C&C criteria. The diagnosis was made 3 weeks earlier by the IADPSG criteria (27 vs 30.5 weeks, P criteria was associated with reduced risk of primary cesarean section (adjusted odds ratio 0.79, 95% confidence interval 0.63-0.998, P 90th percentile, jaundice, admission to neonatal intensive care unit, birth trauma, neonatal hypoglycemia and fetal death. Adopting the IADPSG criteria is associated with improved pregnancy outcomes, at the expense of increased prevalence of gestational diabetes mellitus diagnosis.

  12. Diabetes and related variables among the five main racial groups in South Africa: Comparisons from population studies

    Science.gov (United States)

    Jackson, W. P. U.

    1972-01-01

    We have investigated the total prevalence of diabetes and related factors among representative, randomly chosen samples of the five ethnic groups living in Cape Town, and (East) Indians in Durban. Comparisons are hindered by differences in age distribution of the populations, while small, isolated groups were found to be unrepresentative. The variability of a single individual's blood sugar levels led us to require at least three abnormal values on 2 different days for a positive diagnosis. The use of different criteria for the diagnosis of diabetes varying from ‘lax’ to ‘stringent’ alters the discovered prevalence in our groups by the factor of approximately 2. Mean blood glucose levels rose with middle age but never between childhood and early adulthood. Afternoon screening tests appeared valid, despite the agreed diurnal difference in glucose tolerance figures. Both high screening blood glucose levels and diabetes itself were most common among Indians and coloured people and least among Whites and Bantu, each of the latter having a total diabetes prevalence of approximately 3·5% over age 15. It is noted that the Cape Coloured have more diabetes than any of the constituent races from which they originated. The reasons for such racial differences are unclear—obesity cannot be the explanation here, since, to take one example, the fattest group of all, the Bantu women, have the lowest prevalence of diabetes. We found mild diabetes not uncommon among young people under 20 in the Indian, Malay and coloured population but none among White or Bantu. There was little difference between the sexes, and if anything the poorer people had more diabetes than the better-off. PMID:5069893

  13. Examining the Psychological Pathways to Behavior Change in a Group-Based Lifestyle Program to Prevent Type 2 Diabetes

    OpenAIRE

    Critchley, Christine R.; Hardie, Elizabeth A.; Moore, Susan M.

    2012-01-01

    OBJECTIVE To examine the psychological process of lifestyle change among adults at risk for type 2 diabetes. RESEARCH DESIGN AND METHODS A randomized control trial in which 307 volunteers (intervention, n = 208; wait control, n = 99) diagnosed with prediabetes completed a six-session group-based intervention to promote healthier living. Participants? motivation to change, diet and exercise self-efficacy, mood, knowledge about diabetes, activity levels, healthy eating, waist circumference, and...

  14. The impact of culturally competent diabetes care interventions for improving diabetes-related outcomes in ethnic minority groups: a systematic review.

    Science.gov (United States)

    Zeh, P; Sandhu, H K; Cannaby, A M; Sturt, J A

    2012-10-01

    To examine the evidence on culturally competent interventions tailored to the needs of people with diabetes from ethnic minority groups. MEDLINE (NHS Evidence), CINAHL and reference lists of retrieved papers were searched from inception to September 2011; two National Health Service specialist libraries were also searched. Google, Cochrane and DARE databases were interrogated and experts consulted. Studies were included if they reported primary research on the impact of culturally competent interventions on outcome measures of any ethnic minority group with diabetes. Paper selection and appraisal were conducted independently by two reviewers. The heterogeneity of the studies required narrative analysis. A novel culturally competent assessment tool was used to systematically assess the cultural competency of each intervention. Three hundred and twenty papers were retrieved and 11 included. Study designs varied with a diverse range of service providers. Of the interventions, 64% were found to be highly culturally competent (scoring 90-100%) and 36% moderately culturally competent (70-89%). Data were collected from 2616 participants on 22 patient-reported outcome measures. A consistent finding from 10 of the studies was that any structured intervention, tailored to ethnic minority groups by integrating elements of culture, language, religion and health literacy skills, produced a positive impact on a range of patient-important outcomes. Benefits in using culturally competent interventions with ethnic minority groups with diabetes were identified. The majority of interventions described as culturally competent were confirmed as so, when assessed using the culturally competent assessment tool. Further good quality research is required to determine effectiveness and cost-effectiveness of culturally competent interventions to influence diabetes service commissioners. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  15. The Association of Handgrip Strength and Type 2 Diabetes Mellitus in Six Ethnic Groups: An Analysis of the HELIUS Study.

    Science.gov (United States)

    van der Kooi, Anne-Lotte L F; Snijder, Marieke B; Peters, Ron J G; van Valkengoed, Irene G M

    2015-01-01

    We investigated whether ethnic differences in handgrip strength, a marker of poor muscle strength and quality, is a potential cause of ethnic disparities in type 2 diabetes mellitus. We included 2086 Dutch, 2216 South Asian Surinamese, 2084 African Surinamese, 1786 Ghanaian, 2223 Turkish and 2199 Moroccan origin participants from the HELIUS study. We analyzed ethnic differences in handgrip strength, and its association with type 2 diabetes mellitus using logistic regression analyses adjusted for socio-demographic factors, body composition and lifestyle factors. Additionally, we investigated whether handgrip strength explained the ethnic differences in type 2 diabetes mellitus. We found that handgrip strength differed significantly across ethnic groups. After full adjustment, we found an inverse association with type 2 diabetes mellitus (OR 0.95; 95% CI 0.92-0.97) that did not differ substantially between ethnic groups, men and among women, and lean and overweight individuals. The association was not affected by the measure used to define type 2 diabetes mellitus, but was attenuated by exclusion of people with known diabetes. The ethnic differences in type 2 diabetes mellitus were not explained by handgrip strength (e.g. the OR for the South Asian Surinamese vs. Dutch changed from 5.03; 3.69-6.68 to 4.87; 3.57-6.65). In conclusion, we found large ethnic differences in handgrip strength and a consistent association of low handgrip strength with prevalent type 2 diabetes mellitus. This suggests that handgrip strength may be investigated as a target for intervention or a marker to identify people at risk of type 2 diabetes mellitus.

  16. An ethnographic investigation of healthcare providers' approaches to facilitating person-centredness in group-based diabetes education

    DEFF Research Database (Denmark)

    Stenov, Vibeke; Hempler, Nana Folmann; Reventlow, Susanne

    2017-01-01

    AIM: To investigate approaches among healthcare providers (HCPs) that support or hinder person-centredness in group-based diabetes education programmes targeting persons with type 2 diabetes. METHODS: Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes....... Applying person-centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person-centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person......-centred approaches in a group context. CONCLUSION: Teacher-centredness undermined person-centredness because HCPs primarily delivered disease-specific recommendations, leading to biomedical information overload for participants....

  17. Continuing stability of center differences in pediatric diabetes care: Do advances in diabetes treatment improve outcome? The Hvidoere study group on childhood diabetes

    National Research Council Canada - National Science Library

    de Beaufort, Carine E; Swift, Peter G. F; Skinner, Chas T; Aanstoot, Henk J; Aman, Jan; Cameron, Fergus; Martul, Peo; Chiarelli, Francesco; Daneman, Dennis; Danne, Thomas; Dorchy, Harry; Hoey, Hilary; Kaprio, Eero A; Kaufman, Francine; Kocova, Mirjana; Mortensen, Henrik B; Njolstad, Pal R; Phillip, Moshe; Robertson, Kenneth J; Schoenle, Eugen J; Urakami, Tatsuhiko; Vanelli, Maurizio

    2007-01-01

    between pediatric diabetes centers and to investigate the influence of demography, language communication problems, and changes in insulin regimens on metabolic outcome, hypoglycemia, and ketoacidosis...

  18. Prevalence of Oral Mucosal Disorders in Diabetes Mellitus Patients Compared with a Control Group

    Directory of Open Access Journals (Sweden)

    José González-Serrano

    2016-01-01

    Full Text Available Chronic hyperglycemia is associated with impaired wound healing and higher susceptibility to infections. It is unclear whether patients with diabetes mellitus (DM present more oral mucosal disorders compared to control groups. The objectives were to compare (a the prevalence rates of oral mucosal disorders in the DM and non-DM population and (b the prevalence rates of specific disorders in the DM and non-DM population. Full-text articles were included if they met the following inclusion criteria: (a they must be original articles from scientific journals, (b they must be only cross-sectional studies in English, (c the prevalence of oral mucosal disorders in DM patients must be evaluated, (d results must be compared with a healthy control group, and (e oral mucosal disorders must be specified in DM and non-DM group. All studies showed higher prevalence of oral mucosal disorders in DM patients in relation to non-DM population: 45–88% in type 2 DM patients compared to 38.3–45% in non-DM groups and 44.7% in type 1 DM patients compared to 25% in non-DM population. Tongue alterations and denture stomatitis were the most frequent significant disorders observed. The quality assessment following the Joanna Briggs Institute (JBI Prevalence Critical Appraisal Tool showed the low quality of the existing studies.

  19. Group cognitive behavioural therapy and weight regain after diet in type 2 diabetes: results from the randomised controlled POWER trial

    NARCIS (Netherlands)

    K.A.C. Berk (Kirsten); H. Buijks (Hanneke); A.J.M. Verhoeven (Adrie); Mulder, M.T. (Monique T.); B. Özcan (Behiye); van ’T Spijker, A. (Adriaan); R. Timman (Reinier); J.J. van Busschbach (Jan); E.J.G. Sijbrands (Eric)

    2018-01-01

    textabstractAims/hypothesis: Weight-loss programmes for adults with type 2 diabetes are less effective in the long term owing to regain of weight. Our aim was to determine the 2 year effectiveness of a cognitive behavioural group therapy (group-CBT) programme in weight maintenance after diet-induced

  20. Diabetes

    OpenAIRE

    Smith, Paul

    2003-01-01

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

  1. Group VIB Phospholipase A2 Promotes Proliferation of INS-1 Insulinoma Cells and Attenuates Lipid Peroxidation and Apoptosis Induced by Inflammatory Cytokines and Oxidant Agents

    Science.gov (United States)

    Bao, Shunzhong; Song, Haowei; Tan, Min; Wohltmann, Mary; Ladenson, Jack H.; Turk, John

    2012-01-01

    Group VIB Phospholipase A2 (iPLA2γ) is distributed in membranous organelles in which β-oxidation occurs, that is, mitochondria and peroxisomes, and is expressed by insulin-secreting pancreatic islet β-cells and INS-1 insulinoma cells, which can be injured by inflammatory cytokines, for example, IL-1β and IFN-γ, and by oxidants, for example, streptozotocin (STZ) or t-butyl-hydroperoxide (TBHP), via processes pertinent to mechanisms of β-cell loss in types 1 and 2 diabetes mellitus. We find that incubating INS-1 cells with IL-1β and IFN-γ, with STZ, or with TBHP causes increased expression of iPLA2γ mRNA and protein. We prepared INS-1 knockdown (KD) cell lines with reduced iPLA2γ expression, and they proliferate more slowly than control INS-1 cells and undergo increased membrane peroxidation in response to cytokines or oxidants. Accumulation of oxidized phospholipid molecular species in STZ-treated INS-1 cells was demonstrated by LC/MS/MS scanning, and the levels in iPLA2γ-KD cells exceeded those in control cells. iPLA2γ-KD INS-1 cells also exhibited higher levels of apoptosis than control cells when incubated with STZ or with IL-1β and IFN-γ. These findings suggest that iPLA2γ promotes β-cell proliferation and that its expression is increased during inflammation or oxidative stress as a mechanism to mitigate membrane injury that may enhance β-cell survival. PMID:23213352

  2. Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

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    Gomes Marília B

    2012-10-01

    Full Text Available Abstract Background To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated. Methods This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years ( Results Overall, 18.4% patients had HbA1c levels Conclusions A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.

  3. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

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    Marieke B. Snijder

    2017-01-01

    Full Text Available Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We included 4,541 Dutch, 3,032 South-Asian Surinamese, 4,109 African Surinamese, 2,323 Ghanaian, 3,591 Turkish, and 3,887 Moroccan participants (aged 18–70 y from the HELIUS study. The prevalence of diabetes was analysed by sex, ethnicity, and 10-year age groups. Ethnic differences in the prevalence, awareness, treatment, and control of diabetes were studied by logistic regression. Results. From the age of 31–40 years and older, the prevalence of diabetes was 3 to 12 times higher among ethnic minority groups than that among the Dutch host population. Awareness and medical treatment of diabetes were 2 to 5 times higher among ethnic minorities than that among Dutch. Among those medically treated, only 37–53% had HbA1c levels on target (≤7.0%; only Dutch men had HbA1c levels on target more often (67%. Conclusions. Our results suggest that the age limit for case finding among ethnic minority groups should be lower than that for the general population. Importantly, despite higher awareness and treatment among ethnic minorities, glycemic control was low, suggesting a need for increased efforts to improve the effectiveness of treatment in these groups.

  4. Characterization of type 2 diabetes mellitus burden by age and ethnic groups based on a nationwide survey.

    Science.gov (United States)

    Lopez, Janice M S; Bailey, Robert A; Rupnow, Marcia F T; Annunziata, Kathy

    2014-04-01

    Type 2 diabetes mellitus (T2DM) is the most common form of diabetes. Risk factors for its development include older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. The purpose of this study was to characterize T2DM burden, from a patient perspective, with respect to age and race/ethnicity. Adults aged ≥18 years with T2DM from a large, Internet-based, nationwide survey were retrospectively analyzed. Demographic and clinical characteristics (glycemic control, body mass index [BMI], comorbidities, and diabetes-related complications), hypoglycemic episodes, and medication adherence were used to assess diabetes burden. Degree of burden was compared across age (18-64, 65-74, and ≥75 years) and racial/ethnic (white, African American, Hispanic, Asian, and American Indian) groups. An apparent association was found between glycemic control and medication adherence. Hispanics had the lowest percentage of participants with a hemoglobin A1c (HbA1c) level levels (55.4%) but also had the poorest medication adherence among racial/ethnic groups. Conversely, American Indians and whites had the best glycemic control, HbA1c knowledge, and medication adherence. The 18- to 64-year age group had the poorest glycemic control (28.8%), the most with unknown HbA1c levels (46.3%), and the poorest medication adherence of the age groups. Mean BMIs were high (>30 mg/kg(2)) for all racial/ethnic groups other than the Asian group (28.9 mg/kg(2)). Approximately 71% of Asians were obese or overweight compared with ≥90% in the other racial/ethnic groups. Mean BMIs decreased with increasing age group (34.5, 32.6, and 29.8 kg/m(2) for the age groups of 18-64, 65-74, and ≥75 years, respectively). Regarding diabetes-related comorbidities, the Asian group had the lowest percentages of those with hypertension (39.1%) and hypercholesterolemia (46.6%). The Asian group had the lowest mean Charlson

  5. Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus.

    Science.gov (United States)

    Attridge, Madeleine; Creamer, John; Ramsden, Michael; Cannings-John, Rebecca; Hawthorne, Kamila

    2014-09-04

    Ethnic minority groups in upper-middle-income and high-income countries tend to be socioeconomically disadvantaged and to have a higher prevalence of type 2 diabetes than is seen in the majority population. To assess the effectiveness of culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. A systematic literature search was performed of the following databases: The Cochrane Library, MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and Google Scholar, as well as reference lists of identified articles. The date of the last search was July 2013 for The Cochrane Library and September 2013 for all other databases. We contacted authors in the field and handsearched commonly encountered journals as well. We selected randomised controlled trials (RCTs) of culturally appropriate health education for people over 16 years of age with type 2 diabetes mellitus from named ethnic minority groups residing in upper-middle-income or high-income countries. Two review authors independently assessed trial quality and extracted data. When disagreements arose regarding selection of papers for inclusion, two additional review authors were consulted for discussion. We contacted study authors to ask for additional information when data appeared to be missing or needed clarification. A total of 33 trials (including 11 from the original 2008 review) involving 7453 participants were included in this review, with 28 trials providing suitable data for entry into meta-analysis. Although the interventions provided in these studies were very different from one study to another (participant numbers, duration of intervention, group versus individual intervention, setting), most of the studies were based on recognisable theoretical models, and we tried to be inclusive in considering the wide variety of available culturally appropriate health education.Glycaemic control (as measured by glycosylated haemoglobin A1c (HbA1c

  6. The Effects and Costs of a Group-Based Education Programme for Self-Management of Patients with Type 2 Diabetes. A Community-Based Study

    Science.gov (United States)

    Molsted, Stig; Tribler, Jane; Poulsen, Peter B.; Snorgaard, Ole

    2012-01-01

    The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type 2 diabetes. Seven hundred and two patients…

  7. Enhanced nicotine self-administration and suppressed dopaminergic systems in a rat model of diabetes.

    Science.gov (United States)

    O'Dell, Laura E; Natividad, Luis A; Pipkin, Joseph A; Roman, Francisco; Torres, Ivan; Jurado, Jesus; Torres, Oscar V; Friedman, Theodore C; Tenayuca, John M; Nazarian, Arbi

    2014-11-01

    Patients with diabetes display a heightened propensity to use tobacco; however, it is unclear whether they experience enhanced rewarding effects of nicotine. Thus, this study examined the reinforcing effects of nicotine in a rodent model of diabetes involving administration of streptozotocin (STZ), a drug that is toxic to pancreatic insulin-producing cells. The first study compared STZ- and vehicle-treated rats that had 23-hour access to intravenous self-administration (IVSA) of nicotine or saline and concomitant access to food and water. In order to examine the contribution of dopamine to our behavioral effects, dopamine transporter (DAT), D1 and D2 receptor levels were compared in the nucleus accumbens (NAc) following 10 days of nicotine or saline IVSA. Dopamine levels in the NAc were also compared following nicotine administration. Lastly, nicotine metabolism and dose-dependent effects of nicotine IVSA were assessed. The results revealed that STZ-treated rats displayed enhanced nicotine intake and a robust increase in food and water intake relative to controls. Protein analysis revealed an increase in DAT and a decrease in D1 receptor levels in the NAc of STZ- versus vehicle-treated rats regardless of IVSA condition. STZ-treated rats also displayed suppressed NAc dopamine levels during baseline and in response to nicotine. STZ treatment did not alter our assessment of nicotine metabolism. Furthermore, STZ treatment increased nicotine IVSA in a dose-dependent manner. Our findings suggest that STZ-treatment increased the rewarding effects of nicotine. This suggests that strong reinforcing effects of nicotine may contribute to greater tobacco use in patients with diabetes. © 2013 Society for the Study of Addiction.

  8. Replication of type 2 diabetes candidate genes variations in three geographically unrelated Indian population groups.

    Science.gov (United States)

    Ali, Shafat; Chopra, Rupali; Manvati, Siddharth; Singh, Yoginder Pal; Kaul, Nabodita; Behura, Anita; Mahajan, Ankit; Sehajpal, Prabodh; Gupta, Subash; Dhar, Manoj K; Chainy, Gagan B N; Bhanwer, Amarjit S; Sharma, Swarkar; Bamezai, Rameshwar N K

    2013-01-01

    Type 2 diabetes (T2D) is a syndrome of multiple metabolic disorders and is genetically heterogeneous. India comprises one of the largest global populations with highest number of reported type 2 diabetes cases. However, limited information about T2D associated loci is available for Indian populations. It is, therefore, pertinent to evaluate the previously associated candidates as well as identify novel genetic variations in Indian populations to understand the extent of genetic heterogeneity. We chose to do a cost effective high-throughput mass-array genotyping and studied the candidate gene variations associated with T2D in literature. In this case-control candidate genes association study, 91 SNPs from 55 candidate genes have been analyzed in three geographically independent population groups from India. We report the genetic variants in five candidate genes: TCF7L2, HHEX, ENPP1, IDE and FTO, are significantly associated (after Bonferroni correction, ppopulation. Interestingly, SNP rs7903146 of the TCF7L2 gene passed the genome wide significance threshold (combined P value = 2.05E-08) in the studied populations. We also observed the association of rs7903146 with blood glucose (fasting and postprandial) levels, supporting the role of TCF7L2 gene in blood glucose homeostasis. Further, we noted that the moderate risk provided by the independently associated loci in combined population with Odds Ratio (OR)<1.38 increased to OR = 2.44, (95%CI = 1.67-3.59) when the risk providing genotypes of TCF7L2, HHEX, ENPP1 and FTO genes were combined, suggesting the importance of gene-gene interactions evaluation in complex disorders like T2D.

  9. Replication of type 2 diabetes candidate genes variations in three geographically unrelated Indian population groups.

    Directory of Open Access Journals (Sweden)

    Shafat Ali

    Full Text Available Type 2 diabetes (T2D is a syndrome of multiple metabolic disorders and is genetically heterogeneous. India comprises one of the largest global populations with highest number of reported type 2 diabetes cases. However, limited information about T2D associated loci is available for Indian populations. It is, therefore, pertinent to evaluate the previously associated candidates as well as identify novel genetic variations in Indian populations to understand the extent of genetic heterogeneity. We chose to do a cost effective high-throughput mass-array genotyping and studied the candidate gene variations associated with T2D in literature. In this case-control candidate genes association study, 91 SNPs from 55 candidate genes have been analyzed in three geographically independent population groups from India. We report the genetic variants in five candidate genes: TCF7L2, HHEX, ENPP1, IDE and FTO, are significantly associated (after Bonferroni correction, p<5.5E-04 with T2D susceptibility in combined population. Interestingly, SNP rs7903146 of the TCF7L2 gene passed the genome wide significance threshold (combined P value = 2.05E-08 in the studied populations. We also observed the association of rs7903146 with blood glucose (fasting and postprandial levels, supporting the role of TCF7L2 gene in blood glucose homeostasis. Further, we noted that the moderate risk provided by the independently associated loci in combined population with Odds Ratio (OR<1.38 increased to OR = 2.44, (95%CI = 1.67-3.59 when the risk providing genotypes of TCF7L2, HHEX, ENPP1 and FTO genes were combined, suggesting the importance of gene-gene interactions evaluation in complex disorders like T2D.

  10. Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition.

    Science.gov (United States)

    Olveira, G; García-Luna, P P; Pereira, J L; Rebollo, I; García-Almeida, J M; Serrano, P; Irles, J A; Muñoz-Aguilar, A; Molina, M J; Tapia, M J

    2012-01-01

    By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.

  11. Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: an updated Cochrane Review of randomized controlled trials.

    Science.gov (United States)

    Creamer, J; Attridge, M; Ramsden, M; Cannings-John, R; Hawthorne, K

    2016-02-01

    To give an updated perspective of interventions from additional data collected since our first review, conducted in 2008. This updated Cochrane Review incorporates new information from recent randomized controlled trials on culturally appropriate diabetes health education interventions. An electronic literature search of six databases was repeated, with databases of ongoing trials checked and three journals hand-searched. Meta-analysis was carried out for sufficiently homogeneous outcomes, and common themes among trials were highlighted. A total of 22 new trials were added to the original 11. Meta-analysis of 28 trials containing suitable data showed significant improvements in glycaemic control (HbA1c ) and diabetes knowledge over a period of 24 months, after the delivery of culturally appropriate education to participants, compared with those receiving 'conventional' care. There were no consistent benefits over the control group in other selected outcome measures, and lack of data continued to make analysis of several outcome measures difficult. Research activity in this field has increased considerably over the past 6 years, with culturally appropriate diabetes education showing consistent benefits over conventional care in terms of glycaemic control and diabetes knowledge, sustained in the short- to mid-term. Further research is needed to determine the clinical significance of these improvements and their cost-effectiveness. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  12. Recurrent Myonecrosis Involving Adductor Muscle Group Bilaterally: A Rare Complication of Diabetes Mellitus

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    Manzoor Bhat

    2014-11-01

    Full Text Available Diabetic myonecrosis is a rare and underdiagnosed complication of long-standing, uncontrolled diabetes. It usually occurs in patients with long-standing diabetes in the presence of microvascular complications. Thigh muscles are more commonly affected and the usual presentation is thigh swelling with or without pain, systemic features being rare. Magnetic resonance imaging is the gold standard for diagnosis. Most patients recover spontaneously with bed rest, adequate analgesia and good glycemic control. We present a case of recurrent myonecrosis of adductor muscles of the thigh in a patient with long standing type 2 diabetes mellitus who recovered with conservative management.

  13. Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society.

    Science.gov (United States)

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-03-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  14. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    Science.gov (United States)

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-01-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  15. Continuing stability of center differences in pediatric diabetes care : Do advances in diabetes treatment improve outcome? The Hvidoere study group on childhood diabetes

    NARCIS (Netherlands)

    de Beaufort, Carine E.; Swift, Peter G. F.; Skinner, Chas T.; Aanstoot, Henk J.; Aman, Jan; Cameron, Fergus; Martul, Pedro; Chiarelli, Francesco; Daneman, Dennis; Danne, Thomas; Dorchy, Harry; Hoey, Hilary; Kaprio, Eero A.; Kaufman, Francine; Kocova, Mirjana; Mortensen, Henrik B.; Njolstad, Pal R.; Phillip, Moshe; Robertson, Kenneth J.; Schoenle, Eugen J.; Urakami, Tatsuhiko; Vanelli, Maurizio

    between pediatric diabetes centers and to investigate the influence of demography, language communication problems, and changes in insulin regimens on metabolic outcome, hypoglycemia, and ketoacidosis. RESEARCH DESIGN AND METHODS - This was an observational cross-sectional international study in 21

  16. Metformin Treatment in Type 2 Diabetes in Pregnancy: An Active Controlled, Parallel-Group, Randomized, Open Label Study in Patients with Type 2 Diabetes in Pregnancy

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    Jahan Ara Ainuddin

    2015-01-01

    Full Text Available Aims. To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. Methods. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycemic control. The patients were followed up till delivery. Maternal, and perinatal outcomes and pharmacotherapeutic characteristics were recorded on a proforma. Results. Maternal characteristics were comparable in metformin and insulin treated group. 84.9% patients in metformin group required add-on insulin therapy at mean gestational age of 26.58 ± 3.85 weeks. Less maternal weight gain (P24 hours in metformin group (P<0.01. Significant reduction in cost of treatment was found in metformin group. Conclusion. Metformin alone or with add-on insulin is an effective and cheap treatment option for patients with type 2 diabetes in pregnancy. This trial is registered with clinical trial registration number: Clinical trials.gov NCT01855763.

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

    Science.gov (United States)

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

    2009-08-01

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

  18. Pregnancy outcomes in women with and without gestational diabetes mellitus according to the International Association of the Diabetes and Pregnancy Study Groups criteria.

    Science.gov (United States)

    Bodmer-Roy, Sonja; Morin, Lucie; Cousineau, Jocelyne; Rey, Evelyne

    2012-10-01

    To estimate the incidence of gestational diabetes mellitus (GDM) according to The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and the pregnancy complications in women fulfilling these criteria but who are not considered diabetic according to the Canadian Diabetes Association criteria. We estimated the rate of GDM according to the IADPSG criteria from November 2008 to October 2010. Then, we conducted a chart review to compare maternal and neonatal outcomes between women classified as GDM according to the IADPSG criteria but not by the Canadian Diabetes Association criteria (group 1; n=186) and nondiabetic women according to both criteria (group 2; n=372). Results were expressed as crude (odds ratio [OR]) or adjusted OR and 95% confidence interval (CI). The study has a statistical power of 80% to detect a difference between 16% and 8% in large for gestational age newborns (α level of 0.05; two-tailed). The rate of GDM using the IADPSG criteria was 27.51% (95% CI 25.92-29.11). Group 1 presented similar rates of large-for-gestational-age newborns (9.1% compared with 5.9%, adjusted OR 1.58, 95% CI 0.79-3.13; P=.19), delivery complications (37.1% compared with 30.1%, OR 1.37, 95% CI 0.95-1.98; P=.10), preeclampsia (6.5% compared with 2.7%, adjusted OR 2.40, 95% CI 0.92-6.27; P=.07), prematurity (6.5% compared with 2.7%, OR 1.10, 95% CI 0.53-2.27; P=.85), neonatal complications at delivery (13.4% compared with 9.7%, OR 1.45, 95% CI 0.84-2.49; P=.20), and metabolic complications (10.8% compared with 14.2%, OR 0.73, 95% CI 0.42-1.26; P=.29) compared with group 2. Women classified as nondiabetic by the Canadian Diabetes Association Criteria but considered GDM according to the IADPSG criteria have similar pregnancy outcomes as women without GDM. More randomized studies with cost-effectiveness analyses are needed before implementation of these criteria. II.

  19. Making and maintaining lifestyle changes after participating in group based type 2 diabetes self-management educations: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Marit B Rise

    Full Text Available BACKGROUND: Disease management is crucial in type 2 diabetes. Diabetes self-management education aims to provide the knowledge necessary to make and maintain lifestyle changes. However, few studies have investigated the processes after such courses. The aim of this study was to investigate how participants make and maintain lifestyle changes after participating in group-based type 2 diabetes self-management education. METHODS: Data was collected through qualitative semi-structured interviews with 23 patients who attended educational group programs in Central Norway. The participants were asked how they had used the advice given and what they had changed after the course. RESULTS: Knowledge was essential for making lifestyle changes following education. Three factors affected whether lifestyle changes were implemented: obtaining new knowledge, taking responsibility, and receiving confirmation of an already healthy lifestyle. Four factors motivated individuals to maintain changes: support from others, experiencing an effect, fear of complications, and the formation of new habits. CONCLUSION: Knowledge was used to make and maintain changes in diet, medication and physical activity. Knowledge also acted as confirmation of an already adequate lifestyle. Knowledge led to no changes if diabetes appeared "not that scary" or if changes appeared too time consuming. Those involved in diabetes education need to be aware of the challenges in convincing asymptomatic patients about the benefits of adherence to self-management behaviour.

  20. Effects of a Psychoeducational Group on Mood and Glycemic Control in Adults with Diabetes and Visual Impairments.

    Science.gov (United States)

    Trozzolino, Linda; Thompson, Pamela S.; Tansman, Mara S.; Azen, Stanley P.

    2003-01-01

    This study evaluated the effectiveness of a 12-week psychoeducational group therapy program in improving mood and glycemic control in 48 adults with diabetes and visual impairments. Participants made statistically significant gains in glycemic control. There was a significant positive relationship between control and improvement in depression, but…

  1. Impact of educational group strategy to improve clinical and glycemic parameters in individuals with diabetes and hypertension

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    Danielli Teixeira Lima Favaro

    Full Text Available Objective.To evaluate the impact of an educational group strategy to improve clinical and glycemic parameters in individuals with diabetes and hypertension. Methods. This descriptive prospective study included 172 individuals living in São José do Rio Preto-SP, Brazil, who were enrolled in a well-integrated educational group called HIPERDIA (Record System for Follow-up of Hypertensive and Diabetic Individuals coordinated by a qualified multidisciplinary team. We analyzed sociodemographic, anthropometric, clinical, and laboratory data. Data were collected in the first, fifth, and eighth meeting of the educational group. Results. A total of 68.6% of patients were women, 85.4% were white, 64.0% had an incomplete basic education, 47.7% were retired, 79.7% had been diagnosed with diabetes for 6 or more years, 9.9% were smokers, and 9.9% used alcohol. Individuals' diastolic blood pressure decreased between the fifth and eighth meeting (p<0.05. Between the first and fifth meeting, both fasting glucose levels (p<0.05 and glycated hemoglobin decreased; the latter continue to drop at the fifth and eighth meetings (p<0.001. Anthropometric parameters remained unchanged. Conclusion. The results suggest that an educational group strategy is favorable for controlling diabetes mellitus and hypertension.

  2. Voluntary Organizations and Community Groups as New Partners in Diabetes Self-management and Education: A Critical Interpretative Synthesis

    NARCIS (Netherlands)

    Portillo, M.C.; Regaira, E.; Pumar-Mendez, M.J.; Mujika, A.; Vassilev, I.; Rogers, A.; Wensing, M.; Foss, C.; Knutsen, I.R.; Todorova, E.; Roukova, P.; Kennedy, A.; Serrano, M.; Lionis, C.; Angelaki, A.; Patelarou, E.; Koetsenruijter, J.

    2015-01-01

    PURPOSE: The purpose of this study is to critically review the literature on the role and work of voluntary organizations and community groups and volunteers in diabetes self-management programs. It seeks to explain how these organizations are located and could be integrated further within a broader

  3. The threshold for diagnosing impaired fasting glucose : a position statement by the European Diabetes Epidemiology Group

    NARCIS (Netherlands)

    Forouhi, NG; Balkau, B; Borch-Johnsen, K; Dekker, J; Glumer, C; Qiao, Q; Spijkerman, A; Stolk, R; Tabac, A; Wareham, NJ

    The category of IFG was introduced in the late 1990s to denote a state of non-diabetic hyperglycaemia defined by a fasting plasma glucose (FPG) concentration between 6.1 and 6.9 mmol/l. In 2003 the American Diabetes Association recommended that this diagnostic threshold be lowered to 5.6 mmol/l. The

  4. Development of a Group Intervention for Teens with Type 1 Diabetes

    Science.gov (United States)

    Cespedes-Knadle, Yolanda M.; Munoz, Cynthia E.

    2011-01-01

    Adolescents with Type 1 diabetes (DM1) are at significant risk for depression compared to their non-diabetic counterparts and frequently demonstrate poor glycemic control. Comorbid depression may further exacerbate inadequate metabolic control by creating emotional barriers to effective adherence. Caregiver response to the diagnosis and management…

  5. Effects of streptozotocin-induced diabetes on the pharmacology of rat conduit and resistance intrapulmonary arteries

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    Howarth Frank C

    2009-01-01

    Full Text Available Abstract Background Poor control of blood glucose in diabetes is known to promote vascular dysfunction and hypertension. Diabetes was recently shown to be linked to an increased prevalence of pulmonary hypertension. The aim of this study was to determine how the pharmacological reactivity of intrapulmonary arteries is altered in a rat model of diabetes. Methods Diabetes was induced in rats by the β-cell toxin, streptozotocin (STZ, 60 mg/kg, and isolated conduit and resistance intrapulmonary arteries studied 3–4 months later. Isometric tension responses to the vasoconstrictors phenylephrine, serotonin and PGF2α, and the vasodilators carbachol and glyceryl trinitrate, were compared in STZ-treated rats and age-matched controls. Results STZ-induced diabetes significantly blunted the maximum response of conduit, but not resistance pulmonary arteries to phenylephrine and serotonin, without a change in pEC50. Agonist responses were differentially reduced, with serotonin (46% smaller affected more than phenylephrine (32% smaller and responses to PGF2α unaltered. Vasoconstriction caused by K+-induced depolarisation remained normal in diabetic rats. Endothelium-dependent dilation to carbachol and endothelium-independent dilation to glyceryl trinitrate were also unaffected. Conclusion The small resistance pulmonary arteries are relatively resistant to STZ-induced diabetes. The impaired constrictor responsiveness of conduit vessels was agonist dependent, suggesting possible loss of receptor expression or function. The observed effects cannot account for pulmonary hypertension in diabetes, rather the impaired reactivity to vasoconstrictors would counteract the development of pulmonary hypertensive disease.

  6. Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria.

    Science.gov (United States)

    Noctor, Eoin; Crowe, Catherine; Carmody, Louise A; Saunders, Jean A; Kirwan, Breda; O'Dea, Angela; Gillespie, Paddy; Glynn, Liam G; McGuire, Brian E; O'Neill, Ciarán; O'Shea, P M; Dunne, F P

    2016-10-01

    An increase in gestational diabetes mellitus (GDM) prevalence has been demonstrated across many countries with adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Here, we determine the cumulative incidence of abnormal glucose tolerance among women with previous GDM, and identify clinical risk factors predicting this. Two hundred and seventy women with previous IADPSG-defined GDM were prospectively followed up for 5years (mean 2.6) post-index pregnancy, and compared with 388 women with normal glucose tolerance (NGT) in pregnancy. Cumulative incidence of abnormal glucose tolerance (using American Diabetes Association criteria for impaired fasting glucose, impaired glucose tolerance and diabetes) was determined using the Kaplan-Meier method of survival analysis. Cox regression models were constructed to test for factors predicting abnormal glucose tolerance. Twenty-six percent of women with previous GDM had abnormal glucose tolerance vs 4% with NGT, with the log-rank test demonstrating significantly different survival curves (Pcriteria, had a lower cumulative incidence than women meeting both sets of criteria, both in the early post-partum period (4.2% vs 21.7%, Pdiabetes, gestational week at testing, and BMI at follow-up. The proportion of women developing abnormal glucose tolerance remains high among those with IADPSG-defined GDM. This demonstrates the need for continued close follow-up, although the optimal frequency and method needs further study. © 2016 European Society of Endocrinology.

  7. Effect of Antioxidants and B-Group Vitamins on Risk of Infections in Patients with Type 2 Diabetes Mellitus

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    Awad Alessa

    2013-03-01

    Full Text Available Previous studies have revealed that diabetic patients have a decline in immunity and an increased risk of infections, and this may be associated with poor micronutrient status. The aim of this study was to measure the effect of dietary supplements on risk of infection in patients with type 2 diabetes mellitus. One hundred patients with type 2 diabetes mellitus were randomly assigned to receive an oral dose of daily B-group vitamins and antioxidant vitamins (n = 50 or an identical placebo (n = 50 daily for 90 days. Patients had baseline, three and 12 month assessment for nutritional status, fruits and vegetables intake, physical activity and self-reported infections. Supplementation with antioxidants and B-group vitamins significantly increased the plasma concentration of vitamin E and folate and reduced homocysteine in the intervention group (p-values were 0.006, 0.001 and 0.657, respectively. The number of infections reported by the treatment group after three months of supplements was less than that reported by the placebo group, 9 (27% vs. 15 (36% (p = 0.623. Corresponding numbers of infections at 12 months were 25 (67.5% and 27 (56.3%, respectively (p = 0.488. Up to 90% of the diabetic patients were either overweight or obese with a sedentary life style, and their body weight increased further during three months of follow up. The study showed that multivitamin supplements improved vitamin blood concentrations; however, this did not reduce the number of infections in diabetic patients.

  8. Blood group AB is protective factor for gestational diabetes mellitus: a prospective population-based study in Tianjin, China.

    Science.gov (United States)

    Zhang, Cuiping; Li, Yi; Wang, Leishen; Sun, Shurong; Liu, Gongshu; Leng, Junhong; Guo, Jia; Lv, Li; Li, Weidong; Zhang, Cuilin; Hu, Gang; Yu, Zhijie; Yang, Xilin

    2015-09-01

    The ABO blood types are associated with cancers, cardiovascular diseases and type 2 diabetes mellitus but whether they are also associated with gestational diabetes mellitus (GDM) is unknown. We examined the relationship between the ABO blood types and the risk of GDM in a prospective population-based Chinese cohort. From 2010 to 2012, we recruited 14,198 pregnant women within the first 12 weeks of gestation in Tianjin, China. All women had a glucose challenge test (GCT) at 24-28 gestational weeks, followed by a 75-g 2-h oral glucose tolerance test if the results from GCT were ≥7.8 mmol/L. GDM was diagnosed based on the glucose cut-points of the International Association of Diabetes and Pregnancy Study Group criteria. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for traditional risk factors. Stratified analysis was performed by family history of diabetes (yes versus no). Sensitivity analyses were also performed by using the World Health Organization (WHO) criteria for GDM. Women with blood groups A, B or O (i.e. non-AB) were associated with increased risk of GDM as compared with those with blood group AB (adjusted OR: 1.44, 95% CI: 1.13-1.83). Sensitivity analyses showed that the result was consistent using WHO criteria. The adjusted OR of blood group non-AB versus AB for GDM was enhanced among women with a family history of diabetes (2.69, 1.21-5.96) and attenuated among those without (1.33, 1.03-1.71). Blood group AB was a protective factor against GDM in pregnant Chinese women. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Group cognitive behavioural therapy and weight regain after diet in type 2 diabetes: results from the randomised controlled POWER trial.

    Science.gov (United States)

    Berk, Kirsten A; Buijks, Hanneke I M; Verhoeven, Adrie J M; Mulder, Monique T; Özcan, Behiye; van 't Spijker, Adriaan; Timman, Reinier; Busschbach, Jan J; Sijbrands, Eric J

    2018-01-09

    Weight-loss programmes for adults with type 2 diabetes are less effective in the long term owing to regain of weight. Our aim was to determine the 2 year effectiveness of a cognitive behavioural group therapy (group-CBT) programme in weight maintenance after diet-induced weight loss in overweight and obese adults with type 2 diabetes, using a randomised, parallel, non-blinded, pragmatic study design. We included 158 obese adults (median BMI 36.3 [IQR 32.5-40.0] kg/m2) with type 2 diabetes from the outpatient diabetes clinic of Erasmus MC, the Netherlands, who achieved ≥5% weight loss on an 8 week very low calorie diet. Participants were randomised (stratified by weight loss) to usual care or usual care plus group-CBT (17 group sessions). The primary outcomes were the between-group differences after 2 years in: (1) body weight; and (2) weight regain. Secondary outcomes were HbA1c levels, insulin dose, plasma lipid levels, depression, anxiety, self-esteem, quality of life, fatigue, physical activity, eating disorders and related cognitions. Data were analysed using linear mixed modelling. During the initial 8 week dieting phase, the control group (n = 75) lost a mean of 10.0 (95% CI 9.1, 10.9) kg and the intervention group (n = 83) lost 9.2 (95% CI 8.4, 10.0) kg (p = 0.206 for the between-group difference). During 2 years of follow-up, mean weight regain was 4.7 (95% CI 3.0, 6.3) kg for the control group and 4.0 (95% CI 2.3, 5.6) kg for the intervention group, with a between-group difference of -0.7 (95% CI -3.1, 1.6) kg (p = 0.6). The mean difference in body weight at 2 years was -1.2 (95% CI -7.7, 5.3) kg (p = 0.7). None of the secondary outcomes differed between the two groups. Despite increased treatment contact, a group-CBT programme for long-term weight maintenance after an initial ≥5% weight loss from dieting in obese individuals with type 2 diabetes was not superior to usual care alone. Trialregister.nl NTR2264 FUNDING: The study

  10. Comparative study of I/D polymorphism of ace gene in diabetes type-2 patients and control group in unrelated Gujarati population

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    Doshi Darshan D.

    2015-01-01

    Full Text Available Many of the previous studies indicated that the I/D polymorphism of ACE gene is associated with diabetes type-2. To validate the association of I/D polymorphism in ACE gene, a study was designed in non-diabetic (normal and diabetic type-2 patients of unrelated Gujarati population. The random blood samples from 36 normal and 36 diabetic type -2 patients of above 45 years were collected for the studies. DNA was extracted from blood samples for PCR by using ACE specific primers. The gene and genotype frequencies were estimated for different alleles observed in diabetic as well as in normal healthy persons. In present study, all three genotypes that is, I/I (477bp, I/D (477/190bp, D/D (190bp were observed in samples from normal and diabetic patients. Among all genotypes ID (58.3% has maximum genotypic frequency in diabetic than Non diabetic individuals (44.4%, frequency of II (27.7% is more in Non diabetic individuals than Diabetic individuals (19.4% and genotypic frequency of DD (27.7% is more in Non diabetic than Diabetic individuals (22.22%. The results were not in agreement with so many previous studies. However, recent findings of other studies conducted in different ethnic groups are similar to our findings which do not support that I/D polymorphism are associated with type-2 diabetes.

  11. The impact of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) fasting glucose diagnostic criterion on the prevalence and outcomes of gestational diabetes mellitus in Han Chinese women.

    Science.gov (United States)

    Liao, S; Mei, J; Song, W; Liu, Y; Tan, Y-D; Chi, S; Li, P; Chen, X; Deng, S

    2014-03-01

    The International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed that a one-time value of fasting plasma glucose of 5.1 mmol/l or over at any time of the pregnancy is sufficient to diagnose gestational diabetes. We evaluated the repercussions of the application of this threshold in pregnant Han Chinese women. This is a retrospective study of 5360 (72.3% of total) consecutively recruited pregnant Han Chinese women in one centre from 2008 to 2011. These women underwent a two-step gestational diabetes diagnostic protocol according to the previous American Diabetes Association criteria. The IADPSG fasting plasma glucose criterion was used to reclassify these 5360 women. The prevalence, clinical characteristics and obstetric outcomes were compared among the women classified as having gestational diabetes by the previous American Diabetes Association criteria (approximately 90% were treated), those reclassified as having gestational diabetes by the single IADPSG fasting plasma glucose criterion (untreated), but not as having gestational diabetes by the previous American Diabetes Association criteria, and those with normal glucose tolerance. There were 626 cases of gestational diabetes defined by the previous American Diabetes Association criteria (11.7%) and these cases were associated with increased risks of maternal and neonatal outcomes when compared with the women with normal glucose tolerance. With the IADPSG fasting plasma glucose criterion, another 1314 (24.5%) women were reclassified as having gestational diabetes. Gestational diabetes classified by the IADPSG fasting plasma glucose criterion was associated with gestational hypertension (P = 0.0094) and neonatal admission to nursery (P = 0.035) prior to adjustment for maternal age and BMI, but was no longer a predictor for adverse pregnancy outcomes after adjustment. The simple IADPSG fasting plasma glucose criterion increased the Chinese population with gestational diabetes by 200%. The

  12. Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis

    Science.gov (United States)

    2012-01-01

    Background Diabetes self-management education (DSME) can be delivered in many forms. Group based DSME is widespread due to being a cheaper method and the added advantages of having patient meet and discuss with each other. assess effects of group-based DSME compared to routine treatment on clinical, lifestyle and psychosocial outcomes in type-2 diabetes patients. Methods A systematic review with meta-analysis. Computerised bibliographic database were searched up to January 2008 for randomised controlled trials evaluating group-based DSME for adult type-2 diabetics versus routine treatment where the intervention had at least one session and =/>6 months follow-up. At least two reviewers independently extracted data and assessed study quality. Results In total 21 studies (26 publications, 2833 participants) were included. Of all the participants 4 out of 10 were male, baseline age was 60 years, BMI 31.6, HbA1c 8.23%, diabetes duration 8 years and 82% used medication. For the main clinical outcomes, HbA1c was significantly reduced at 6 months (0.44% points; P = 0.0006, 13 studies, 1883 participants), 12 months (0.46% points; P = 0.001, 11 studies, 1503 participants) and 2 years (0.87% points; P self-management skills also improved significantly at 6 months (SMD 0.55; P = 0.01, 4 studies, 534 participants). For the main psychosocial outcomes, there were significant improvement for empowerment/self-efficacy (SMD 0.28, P = 0.01, 2 studies, 326 participants) after 6 months. For quality of life no conclusion could be drawn due to high heterogeneity. For the secondary outcomes there were significant improvements in patient satisfaction and body weight at 12 months for the intervention group. There were no differences between the groups in mortality rate, body mass index, blood pressure and lipid profile. Conclusions Group-based DSME in people with type 2 diabetes results in improvements in clinical, lifestyle and psychosocial outcomes

  13. Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group

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    Ana Maria da Silva Sousa

    2016-06-01

    Full Text Available SUMMARY Objective: To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM through a phone contact. Method: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Results: Most patients 119/122 patients (97.5% were managing to do self glucose monitoring. Twenty-one patients (17.2% reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7% patients said they did not; the meal frequency was not reached by 23/122 (18.9% of the women, and forty-seven (38.5% of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Conclusion: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

  14. Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group.

    Science.gov (United States)

    Sousa, Ana Maria da Silva; Fiuza, Daine; Mikami, Fernanda Cristina Ferreira; Abrão, Karen Cristine; Francisco, Rossana Pulcineli Vieira; Zugaib, Marcelo

    2016-01-01

    To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

  15. Cellular localization of kinin B1 receptor in the spinal cord of streptozotocin-diabetic rats with a fluorescent [Nα-Bodipy]-des-Arg9-bradykinin

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    Gaudreau Pierrette

    2009-03-01

    Full Text Available Abstract Background The kinin B1 receptor (B1R is upregulated by pro-inflammatory cytokines, bacterial endotoxins and hyperglycaemia-induced oxidative stress. In animal models of diabetes, it contributes to pain polyneuropathy. This study aims at defining the cellular localization of B1R in thoracic spinal cord of type 1 diabetic rats by confocal microscopy with the use of a fluorescent agonist, [Nα-Bodipy]-des-Arg9-BK (BdABK and selective antibodies. Methods Diabetes was induced by streptozotocin (STZ; 65 mg/kg, i.p.. Four days post-STZ treatment, B1R expression was confirmed by quantitative real-time PCR and autoradiography. The B1R selectivity of BdABK was determined by assessing its ability to displace B1R [125I]-HPP-desArg10-Hoe140 and B2R [125I]-HPP-Hoe 140 radioligands. The in vivo activity of BdABK was also evaluated on thermal hyperalgesia. Results B1R was increased by 18-fold (mRNA and 2.7-fold (binding sites in the thoracic spinal cord of STZ-treated rats when compared to control. BdABK failed to displace the B2R radioligand but displaced the B1R radioligand (IC50 = 5.3 nM. In comparison, IC50 values of B1R selective antagonist R-715 and B1R agonist des-Arg9-BK were 4.3 nM and 19 nM, respectively. Intraperitoneal BdABK and des-Arg9-BK elicited dose-dependent thermal hyperalgesia in STZ-treated rats but not in control rats. The B1R fluorescent agonist was co-localized with immunomarkers of microglia, astrocytes and sensory C fibers in the spinal cord of STZ-treated rats. Conclusion The induction and up-regulation of B1R in glial and sensory cells of the spinal cord in STZ-diabetic rats reinforce the idea that kinin B1R is an important target for drug development in pain processes.

  16. Profile of Nigerians with diabetes mellitus - Diabcare Nigeria study group (2008: Results of a multicenter study

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    Sunday Chinenye

    2012-01-01

    Full Text Available Background: Diabetes Mellitus is the commonest endocrine-metabolic disorder in Nigeria similar to the experience in other parts of the world. The aim was to assess the clinical and laboratory profile, and evaluate the quality of care of Nigerian diabetics with a view to planning improved diabetes care. Materials and Methods: In a multicenter study across seven tertiary health centers in Nigeria, the clinical and laboratory parameters of diabetic out-patients were evaluated. Clinical parameters studied include type of diabetes, anthropometry, and blood pressure (BP status, chronic complications of diabetes, and treatment types. Laboratory data assessed included fasting plasma glucose (FPG, 2-h post-prandial (2-HrPP glucose, glycated hemoglobin (HbA1c, urinalysis, serum lipids, electrolytes, urea, and creatinine. Results: A total of 531 patients, 209 (39.4% males and 322 (60.6% females enrolled. The mean age of the patients was 57.1 ± 12.3 years with the mean duration of diabetes of 8.8 ± 6.6 years. Majority (95.4% had type 2 diabetes mellitus (DM compared to type 1 DM (4.6%, with P < 0.001. The mean FPG, 2-HrPP glucose, and HbA1c were 8.1 ± 3.9 mmol/L, 10.6 ± 4.6 mmol/L, and 8.3 ± 2.2%, respectively. Only 170 (32.4% and 100 (20.4% patients achieved the ADA and IDF glycemic targets, respectively. Most patients (72.8% did not practice self-monitoring of blood glucose. Hypertension was found in 322 (60.9%, with mean systolic BP 142.0 ± 23.7 mmHg, and mean diastolic BP 80.7 ± 12.7 mmHg. Diabetic complications found were peripheral neuropathy (59.2%, retinopathy (35.5%, cataracts (25.2%, cerebrovascular disease (4.7%, diabetic foot ulcers (16.0%, and nephropathy (3.2%. Conclusion: Most Nigerian diabetics have suboptimal glycemic control, are hypertensives, and have chronic complications of DM. Improved quality of care and treatment to target is recommended to reduce diabetes-related morbidity and mortality.

  17. Prevalence and features of pancreatic islet cell autoimmunity in women with gestational diabetes from different ethnic groups.

    Science.gov (United States)

    Kousta, E; Lawrence, N J; Anyaoku, V; Johnston, D G; McCarthy, M I

    2001-07-01

    To assess the prevalence and characteristics of islet cell autoimmunity amongst women with gestational diabetes selected from South Asian and Afro-Caribbean as well as European populations. Cross-sectional retrospective survey of subject cohort. Three hundred and twenty-one women with a recent history of gestational diabetes (173 European, 86 South Asian and 62 Afro-Caribbean), a median (range) of 22 (1-150) months postpartum. Antibodies to Glutamic acid decarboxylase were found in 13 (4%) of these women. There was no difference in the prevalence of anti-glutamic acid decarboxylase positivity between the three ethnic groups (European 4.6%, South Asian 3.5%, Afro-Caribbean 3.2%). Anti-glutamic acid decarboxylase positive women were leaner than anti-glutamic acid decarboxylase negative women (body mass index, median (upper-lower quartile) 23.9 (22.5-26.7) vs 26.6 (23.4-30.5)kg/m2, P = 0.03, P = 0.049 allowing for ethnicity). There was no difference between glutamic acid decarboxylase-positive and glutamic acid decarboxylase-negative women for age, family history of diabetes, waist/hip ratio, prevalence of insulin treatment during pregnancy, postpartum glucose status, lipid profile and indices of insulin action and beta-cell function. Markers of islet cell autoimmunity are found as frequently in gestational diabetes women of South Asian and Afro-Caribbean origin, as they are in European subjects. Identification of future risk of type 1 diabetes is relevant to the planning of clinical management and intervention strategies in women with gestational diabetes of all major ethnic groups.

  18. Effectiveness of Group Cognitive Bbehavioral Therapy on Anxiety, Depression and Glycemic Control in Children with Type 1 Diabetes

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    S Ahmadi

    2014-04-01

    Full Text Available The present study aimed to investigate the effectiveness of group cognitive behavioral therapy in reducing anxiety and depression and glycemic control in children with type I diabetes. The study was quasi- experimental with a pre-test, post-test design with control group. For this purpose, 30 children with diabetes were selected from Imam Reza Hospital in Mashhad. The children were randomly assigned into two experimental group (15 and control group (15. The experimental group was undergone eight 2-hour sessions of cognitive-behavioral training. Before and after the intervention, the Multidimensional Anxiety Scale for Children, which included four components of social anxiety, physical symptoms, harm avoidance, and separation anxiety, and Children Depression Inventory was administrated in both groups. The findings from the covariance analysis test revealed that depression and anxiety and glycemic control in experimental group was controlled at post-test and depression score in experimental group compared to the control group at post-test was decreased. The findings from the multivariate covariance analysis test between components of, physical symptoms, harm avoidance, separation anxiety, and social anxiety revealed meaningful differences between the two groups in social anxiety post-test score. Thus, cognitive behavior therapy can be effective for depression, anxiety, and blood sugar control in children.

  19. Effectiveness of Group Cognitive-Behavioral Therapy on Anxiety, Depression and Glycemic Control in Children with Type 1 Diabetes

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    Somaye Ahmadi

    2014-06-01

    Full Text Available Introduction: The present study aimed to investigate the effectiveness of group cognitive behavioral therapy in reducing anxiety and depression and glycemic control in children with type I diabetes. Methods and Matherials: The study was quasi- experimental with a pre-test, post-test design with control group. For this purpose, 30 children with diabetes were selected from Imam Reza Hospital in Mashhad. The children were randomly assigned into two experimental group (15 and control group (15. The experimental group was undergone eight 2-hour sessions of cognitive-behavioral training. Before and after the intervention, the Multidimensional Anxiety Scale for Children, which included four components of social anxiety, physical symptoms, harm avoidance, and separation anxiety, and Children Depression Inventory was administrated in both groups. Results: The findings from the covariance analysis test revealed that depression and anxiety and glycemic control in experimental group was controlled at post-test and depression score in experimental group compared to the control group at post-test was decreased. The findings from the multivariate covariance analysis test between components of, physical symptoms, harm avoidance, separation anxiety, and social anxiety revealed meaningful differences between the two groups in social anxiety post-test score. Conclusions: According to the article, cognitive behavior therapy can be effective for depression, anxiety, and blood sugar control in children.

  20. Diabetic Eye Disease

    Science.gov (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetic Eye Disease What is diabetic eye disease? Diabetic eye disease is a group ... eye diseases that can threaten your sight are Diabetic retinopathy The retina is the inner lining at ...

  1. [Clinical recommendations for sport practice in diabetic patients (RECORD Guide). Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN)].

    Science.gov (United States)

    Gargallo-Fernández, Manuel; Escalada San Martín, Javier; Gómez-Peralta, Fernando; Rozas Moreno, Pedro; Marco Martínez, Amparo; Botella-Serrano, Marta; Tejera Pérez, Cristina; López Fernández, Judith

    2015-01-01

    Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  2. Hypoglycemia in type 2 diabetes: Standpoint of an experts′ committee (India hypoglycemia study group

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    Mohan Viswanathan

    2012-01-01

    Full Text Available The epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can substantially reduce morbidity have made the effective treatment of hyperglycemia a top priority. Despite compelling evidence that tight glycemic control is crucial for delaying disease progression, increased risk of hypoglycemia associated with such control underscore the complexity of diabetes management. In most cases, hypoglycemia results from an excess of insulin, either absolute or relative to the available glucose substrate and the factors perhaps exacerbating the risk are pharmacokinetic imperfections, behavioral, co-morbidities etc. Additionally, many patients remain undiagnosed, and many diagnosed patients are not treated appropriately. In this article, the challenges of hypoglycemia, confronting health care providers and their patients with diabetes, are discussed for making treatment decisions that will help minimize risk of hypoglycemia and eventually overcome formidable barriers to optimal diabetes management. Strategies to treat and minimize the frequency and severity of hypoglycemia without compromising on glycemic goals are also presented.

  3. The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial

    DEFF Research Database (Denmark)

    Rosenbek Minet, L K; Wagner, L; Lønvig, E M

    2011-01-01

    education programme, 349 patients were randomised to either a usual care control group or an intervention group, which received up to five individual counselling sessions in 1 year based on MI, in addition to usual care. A randomised parallel design was used and open-label allocation was done by random...... diabetes mellitus, were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark. Exclusion criteria included pregnancy, severe debilitating disease and cognitive deficit. Out of 469 patients who attended the group...... in dealing with diabetes compared with the control group (mean change score = -0.387, p = 0.002) following 1 year of intervention. CONCLUSION/INTERPRETATION: We were unable to demonstrate any benefit, over or above usual care, of MI in patients with diabetes who have just completed a diabetes education...

  4. Diabetes

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth R

    2015-01-01

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

  5. Feto-maternal outcomes in women with and without gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria.

    Science.gov (United States)

    Nayak, Prasanta Kumar; Mitra, Subarna; Sahoo, Jaya Prakash; Daniel, Mary; Mathew, Agnes; Padma, Alaganandam

    2013-01-01

    Gestational diabetes mellitus (GDM) is responsible for majority of pregnancies complicated with diabetes mellitus. Both the screening (universal vs. selective) and the diagnostic criteria of GDM has been the subject of considerable controversy. This prospective cohort study was undertaken at Pondicherry Institute of Medical Sciences, Puducherry from August 2011 to July 2012. All the patients attending antenatal clinic underwent oral glucose tolerance test (OGTT) with 75g of anhydrous glucose between 24 and 32 weeks of gestation. Those patients diagnosed as GDM according to IADPSG diagnostic criteria were treated with diet and physical activity with or without insulin. All the antenatal and perinatal outcomes were noted. The prevalence of GDM in our study was 27% (83/304). Out of all the GDM patients, 87% (72/83) cases were diagnosed by raised FBS alone or with other two values. A significant family history of diabetes mellitus was found among GDM mothers compared to non-GDM group (10.8% vs. 3.6%, p=0.01). Insulin was required only in 8 patients for glycemic control. The GDM patients delivered at significantly lower gestational age (p=0.02) with more antenatal complications (25% vs. 12%, p=0.02). Among neonatal outcomes, there was a significant difference only in the need for NICU admission>24h between GDM and non-GDM groups (p=0.02). The prevalence of GDM increases with universal screening using IADPSG diagnostic criteria in India. The antenatal complications are present in up to one fourth of these patients. Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Angadi Rajasab Nilofer

    2012-01-01

    Full Text Available Background: Gestational diabetes mellitus (GDM is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. The complications associated with GDM can be prevented by early recognition, intense monitoring and proper treatment. Aims: The present study was done to screen the high-risk pregnancy group for GDM, to find the incidence of abnormal results on screening and to correlate the abnormal results with the maternal and fetal outcomes. The study was done in a tertiary care hospital and teaching institute. It was a prospective cohort study. Materials and Methods: Selective screening for GDM was done in 150 pregnant women with high-risk factors. Screening was done with 50 g glucose challenge test (GCT after 18 weeks, and if GCT was negative then the test was repeated after 28 weeks of pregnancy. The patients who were having an abnormal GCT were subjected to 100 g oral glucose tolerance test (OGTT. All GDM patients were followed up and treated with diet and/or insulin therapy till delivery to know maternal and fetal outcomes. The period of study was from April 2008 to March 2009. Results: 7.3% of study population was OGCT positive. 6% of the study population was OGTT positive. Age >25 years, obesity, family history of DM, and past history of GDM were the risk factors significantly associated with GDM. One newborn had hypoglycemia and one had hyperbilirubinemia. The fetal and maternal outcome in GDM patients was good in our study due to early diagnosis and intervention. Conclusion: Women with GDM are at an increased risk for adverse obstetric and perinatal outcome. The increased morbidity in GDM is preventable by meticulous antenatal care.

  7. Diabetes

    Data.gov (United States)

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

  8. Effects of a Topical Saffron (Crocus sativus L) Gel on Erectile Dysfunction in Diabetics: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Trial.

    Science.gov (United States)

    Mohammadzadeh-Moghadam, Hossein; Nazari, Seyed Mohammad; Shamsa, Ali; Kamalinejad, Mohammad; Esmaeeli, Habibollah; Asadpour, Amir Abbas; Khajavi, Abdoljavad

    2015-10-01

    Erectile dysfunction is a man's persistent or recurrent inability to achieve and maintain erection for a satisfactory sexual relationship. As diabetes is a major risk factor for erectile dysfunction, the prevalence of erectile dysfunction among diabetic men has been reported as 35% to 90%. This randomized, parallel-group, double-blind, placebo-controlled trial investigated the effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetic men. Patients were randomly allocated to 2 equal groups (with 25 patients each). The intervention group was treated with topical saffron, and the control received a similar treatment with placebo. The 2 groups were assessed using the International Index of Erectile Function Questionnaire before the intervention and 1 month after the intervention. Compared to placebo, the prepared saffron gel could significantly improve erectile dysfunction in diabetic patients (P saffron can be considered as a treatment option for diabetic men with erectile dysfunction. © The Author(s) 2015.

  9. Comparison of the world health organization and the International association of diabetes and pregnancy study groups criteria in diagnosing gestational diabetes mellitus in South Indians

    Directory of Open Access Journals (Sweden)

    Sivagnanam Nallaperumal

    2013-01-01

    Full Text Available Aim: We aimed to compare the International Association of Diabetes and Pregnancy Study Groups (IADPSG and the World Health Organization (WHO criteria to diagnose gestational diabetes mellitus (GDM in Chennai, India. Materials and Methods: We reviewed the retrospective data of 1351 pregnant women who underwent screening for GDM at four selected diabetes centers at Chennai (three private and one government. All women underwent an oral glucose tolerance test using 75g glucose load and fasting, 1-h, and 2-h samples were collected. The IADPSG and WHO criteria were compared for diagnosis of GDM. Results: A total of 839 women had GDM by either the IADPSG or the WHO criteria, of whom the IADPSG criteria identified 699 and the WHO criteria also identified 699 women as having GDM. However, only 599/839 women (66.6% were identified by both criteria. Thus, 140/839 women (16.7% were missed by both the IADPSG and the WHO criteria. 687/699 (98.2% of the women with GDM were identified by the WHO criteria. In contrast, each value of IADPSG criteria i.e., fasting, 1 h, and 2 h identified only 12.5%, 14%, and 22%, respectively. Conclusions: A single WHO cut-point of 2 h > 140 mg/dl appears to be suitable for large-scale screening for GDM in India and other developing countries.

  10. Use of the National Diabetes Data Group and the Carpenter-Coustan criteria for assessing gestational diabetes mellitus and risk of adverse pregnancy outcome.

    Science.gov (United States)

    Lu, Mei-Chun; Huang, Song-Shan; Yan, Yuan-Horng; Wang, Panchalli

    2016-08-17

    The influence of different diagnostic thresholds for gestational diabetes mellitus (GDM) on pregnancy outcomes is not fully understood. Degrees of glucose intolerance according to the Carpenter-Coustan (CC) criteria were less severe than the National Diabetes Data Group (NDDG) criteria for GDM. Recent studies have shown inconsistent results regarding the risk of adverse pregnancy outcomes between the NDDG and CC criteria. Therefore, the objective of this study was to investigate whether pregnant women who met only the CC criteria but not the NDDG criteria and those who met the NDDG criteria had increased risks of adverse pregnancy outcomes compared to a negative screening group. A total of 11,486 Taiwanese pregnancies were enrolled in a retrospective cohort study. The study subjects were classified as follows: (1) negative screening group: women with negative 50-g glucose challenge test (GCT) results, (2) false-positive screening group: women with positive GCT results and negative 100-g OGTT results according to both CC and NDDG criteria, (3) CC-only-GDM group: women with positive GCT results plus GDM diagnosis meeting the CC but not the NDDG criteria, and (4) NDDG-GDM group: women diagnosed with GDM using the NDDG criteria. Multiple mixed effects logistic regression analysis was used to examine the relationships between the groups and pregnancy outcomes. There were 9002 (78.4 %), 1776 (15.5 %), 251 (2.2 %), and 457 (4.0 %) study pregnancies in the 4 groups. Compared with the negative screening group, the maternal outcomes were not different within groups except for gestational hypertension/preeclampsia. For neonatal outcomes, the CC-only-GDM group had significantly greater risks of macrosomia, low birth weight, and admission to a neonatal intensive care unit [adjusted odds ratio (aOR), (95 % confidence interval, CI): 2.73 (1.18-6.31), 1.64 (1.01-2.64), and 1.61 (1.05-2.46), respectively]. The NDDG-GDM group also showed significantly greater risks, and the

  11. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    Science.gov (United States)

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-01-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. ATLANTIC-DIP: prevalence of metabolic syndrome and insulin resistance in women with previous gestational diabetes mellitus by International Association of Diabetes in Pregnancy Study Groups criteria.

    Science.gov (United States)

    Noctor, Eoin; Crowe, Catherine; Carmody, Louise A; Kirwan, Breda; O'Dea, Angela; Glynn, Liam G; McGuire, Brian E; O'Shea, Paula M; Dunne, Fidelma P

    2015-02-01

    Women with previous gestational diabetes (GDM) are a high-risk group for future development of diabetes, metabolic syndrome, and cardiovascular disease. The new International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria significantly increase the number of women diagnosed with GDM. The long-term metabolic outcome in these women is unknown. We set out to determine the prevalence of metabolic syndrome, using adult treatment panel-III criteria; and insulin resistance, using HOMA2-IR, in white European women with previous GDM. Using a cohort design, we invited women meeting IADPSG GDM criteria across four Irish antenatal centres between 2007 and 2010 to participate. Two hundred and sixty-five women with previous values meeting IADPSG criteria for GDM participated (44 % of the population eligible for participation). Mean age was 36.7 years (SD 5.0). These women were compared with a randomly selected control group of 378 women (mean age 37.6 years, SD 5.1) known to have normal glucose tolerance (NGT) in pregnancy during the same period. A total of 25.3 % of women with previous IADPSG-defined GDM met metabolic syndrome criteria, compared to 6.6 % of women with NGT [at 2.6 (SD 1.0) vs. 3.3 years (SD 0.7) post-partum]. The prevalence of HOMA2-IR >1.8 was higher in women with previous IADPSG-defined GDM (33.6 vs. 9.1 % with NGT, p criteria demonstrate a greater than threefold prevalence of metabolic syndrome compared to women with NGT in pregnancy. Efforts to prevent projected long-term consequences of this should focus on interventions both in the preconception and post-partum periods.

  13. Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling

    DEFF Research Database (Denmark)

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

    2011-01-01

    Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness...... of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients....

  14. Health-related quality of life and self-related 1 health in patients 2 with type 2 diabetes: Effects of group-based rehabilitation - versus individual counseling

    DEFF Research Database (Denmark)

    Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert

    2012-01-01

    Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness...... of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients....

  15. Prevalence of gestational diabetes in a group of women receiving treatment at the Mexican Institute of Social Security in Aguascalientes, Mexico.

    Science.gov (United States)

    López-de la Peña, X A; Cájero Avelar, J J; De León Romo, L F

    1997-01-01

    The objective of this work was to determine the prevalence and associated clinical variables of gestational diabetes in a group of pregnant women, using a prospective, longitudinal and comparative study. The setting where the study was performed was an urban General Hospital, and outpatient clinics of the Instituto Mexicano del Seguro Social in Aguascalientes City, Mexico. The subjects were 187 pregnant women receiving prenatal care in two health care outpatient clinics where they had given informed consent for a 1-year period. All selected women without a history of diabetes mellitus were studied and scheduled for a full oral glucose tolerance test (OGTT) performed at 24-28 weeks of gestation. Gestational diabetes was diagnosed according to the American Diabetes Association. Results are shown for comparative purposes in three groups: 167 women with normal OGTT, 7 women with one OGTT abnormal value, and 13 women with OGTT criteria for gestational diabetes. The study protocol was approved by the Institutional Review Board. We found a prevalence of 6.9% of gestational diabetes in our study group, and significant differences (p diabetes, obesity of 90 kg or more, and age > 35 years. Body mass index mean was over 25 kg/m2 in all groups. The 6.9% prevalence of gestational diabetes we found is higher than data between 3.9 and 6% previously reported in Mexico. This could reflect a selection bias of our sample; however, it represents a serious public health problem. Appropriate screening, diagnosis, monitoring, and treatment must be implemented.

  16. [Level at which control objectives are reached in patients in different population groups with type 2 diabetes].

    Science.gov (United States)

    Herrero, A; Pinillos, J; Sabio, P; Martín, J L; Garzón, G; Gil, Á

    2016-11-23

    There is evidence of increased macro- and micro-vascular risk in diabetic patients. The objective of this study was to determine the level of control in patients in different population groups with type 2 diabetes. Descriptive cross-sectional study. Primary care. Madrid Health Service. Year: 2014. Patients over 14 years with type 2 diabetes. Number of patientes: n=6674. Variables on the degree of control (HbA1c, systolic blood pressure [SBP], diastolic blood pressure [DBP], LDL-c) and variables on patient characteristics (demographic, other cardiovascular risk factors, complications). The mean age of patients with controlled HbA1c was 67.8 years vs. 62.9 years in the uncontrolled (P 140mmHg or DBP> 90mmHg. Over 25% of patients with hypertension or DL and uncontrolled levels were not receiving drug treatment. Control was improved in all groups, especially in younger patients, with particularly high cardiovascular risk by the presence of other cardiovascular risk factors or macroangiopathy. A significant percentage of patients with uncontrolled BP and cLDL were not diagnosed or receiving drug treatment. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Evaluation of the prevalence of gestational diabetes mellitus in North Indians using the International Association of Diabetes and Pregnancy Study groups (IADPSG) criteria.

    Science.gov (United States)

    Gopalakrishnan, V; Singh, R; Pradeep, Y; Kapoor, D; Rani, A K; Pradhan, S; Bhatia, E; Yadav, S B

    2015-01-01

    Currently, there is controversy regarding the diagnosis of gestational diabetes mellitus (GDM) as per the newer International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. We studied the prevalence and associations of GDM in North Indians, diagnosed by the IADPSG criteria. We conducted a cross-sectional study on 332 pregnant women, predominantly belonging to lower and middle socioeconomic strata. The women were screened for GDM between 24 weeks and 28 weeks of gestation by 75g oral glucose tolerance test (OGTT) and GDM diagnosed by the IADPSG criteria. The prevalence of GDM was 41.9% [95% Confidence interval (CI) 36.6-47.2%]. Amongst the women diagnosed to have GDM, 91.4% had abnormal fasting plasma glucose (FPG), while 1-h and 2-h post-glucose (PG) levels were abnormal in 18.7% and 17.3% of women, respectively. No maternal factors were significantly associated with GDM. Birth weight of the neonates was similar in women with GDM as compared to those with normal glucose tolerance. In the entire group, fasting glucose levels were associated with the weight of the patient while 1-h PG levels were associated with weight, height, socioeconomic score, and parity. There is a very high prevalence rate of GDM using the IADPSG criteria in North Indian women of low and middle socioeconomic strata. Further studies are needed to assess the utility of applying these criteria in settings with limited resources.

  18. Investigation on the suitability of the International Association of Diabetes and Pregnancy Study Group diagnostic criteria for gestational diabetes mellitus in China.

    Science.gov (United States)

    Shang, M; Lin, L; Ma, L; Yin, L

    2014-02-01

    The aim of this study was to compare pregnancy outcomes of Chinese women diagnosed with gestational hyperglycaemia by the well-established American Diabetes Association (ADA) criteria, with those women meeting the newer criteria established by International Association of Diabetes and Pregnancy Study Groups (IADPSG). The study subjects consisted of 6,201 pregnant Chinese women with a singleton pregnancy who had received prenatal care and delivered between December 2008 and December 2011. Women who were screened positive with 1 h glucose load of ≥ 7.8 mmol/l underwent a diagnostic 3 h oral glucose tolerance test. Gestational hyperglycaemia was diagnosed using the ADA criteria and re-diagnosed according to the IADPSG criteria. The correlation between the incidences of adverse pregnant outcomes with gestational hyperglycaemia was analysed. In total, 570 patients (9.19% of 6,201) met the ADA criteria and 676 (10.90% of 6,201) met the IADPSG criteria. The 518 patients who met both standards showed a reduced caesarean section rate, as compared with 158 patients who only met the IADPSG standard and received no intervention (71.2% vs 79.7%, p criteria identified a group of women previously classified as normal according to the ADA criteria, but revealing poor pregnancy outcomes and requiring management. Therefore, we conclude that the IADPSG criteria are more suitable for the diagnosis of gestational hyperglycaemia in China.

  19. Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study

    Science.gov (United States)

    Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M

    2015-01-01

    Objectives To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators. Design A cross-sectional study. Setting All Dutch care groups (n=97). Participants 23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers. Primary outcomes The association between quality management, overall and in 6 domains (‘organisation of care’, ‘multidisciplinary teamwork’, ‘patient centredness’, ‘performance management’, ‘quality improvement policy’ and ‘management strategies’) on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53 mmol/mol (7%); low-density lipoprotein cholesterol below 2.5 mmol/L; and systolic blood pressure below 140 mm Hg) by weighted univariable linear regression. Results The domain ‘management strategies’ was significantly associated with the percentage of patients with a glycated haemoglobin management were not associated with aggregate process or outcome indicators. Conclusions This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains uncertain whether this

  20. Study Protocol: The Norfolk Diabetes Prevention Study [NDPS]: a 46 month multi - centre, randomised, controlled parallel group trial of a lifestyle intervention [with or without additional support from lay lifestyle mentors with Type 2 diabetes] to prevent transition to Type 2 diabetes in high risk groups with non - diabetic hyperglycaemia, or impaired fasting glucose.

    Science.gov (United States)

    Pascale, Melanie; Murray, Nikki; Bachmann, Max; Barton, Garry; Clark, Allan; Howe, Amanda; Greaves, Colin; Sampson, Mike

    2017-01-06

    This 7 year NIHR programme [2011-2018] tests the primary hypothesis that the NDPS diet and physical activity intervention will reduce the risk of transition to type 2 diabetes (T2DM) in groups at high risk of Type 2 diabetes. The NDPS programme recognizes the need to reduce intervention costs through group delivery and the use of lay mentors with T2DM, the realities of normal primary care, and the complexity of the current glycaemic categorisation of T2DM risk. NDPS identifies people at highest risk of T2DM on the databases of 135 general practices in the East of England for further screening with ab fasting plasma glucose and glycosylated haemoglobin [HbA1c]. Those with an elevated fasting plasma glucose [impaired fasting glucose or IFG] with or without an elevated HbA1c [non -diabetic hyperglycaemia; NDH] are randomised into three treatment arms: a control arm receiving no trial intervention, an arm receiving an intensive bespoke group-based diet and physical activity intervention, and an arm receiving the same intervention with enhanced support from people with T2DM trained as diabetes prevention mentors [DPM]. The primary end point is cumulative transition rates to T2DM between the two intervention groups, and between each intervention group and the control group at 46 months. Participants with screen detected T2DM are randomized into an equivalent prospective controlled trial with the same intervention and control arms with glycaemic control [HbA1c] at 46 months as the primary end point. Participants with NDH and a normal fasting plasma glucose are randomised into an equivalent prospective controlled intervention trial with follow up for 40 months. The intervention comprises six education sessions for the first 12 weeks and then up to 15 maintenance sessions until intervention end, all delivered in groups, with additional support from a DPM in one treatment arm. The NDPS programme reports in 2018 and will provide trial outcome data for a group delivered

  1. Enhanced expression of two discrete isoforms of matrix metalloproteinase-2 in experimental and human diabetic nephropathy.

    Directory of Open Access Journals (Sweden)

    Sang Soo Kim

    Full Text Available We recently reported on the enhanced expression of two isoforms of matrix metalloproteinase-2 (MMP-2 in human renal transplantation delayed graft function. These consist of the conventional secreted, full length MMP-2 isoform (FL-MMP-2 and a novel intracellular N-Terminal Truncated isoform (NTT-MMP-2 generated by oxidative stress-mediated activation of an alternate promoter in the MMP-2 first intron. Here we evaluated the effect of hyperglycemia and diabetes mellitus on the in vitro and in vivo expression of the two MMP-2 isoforms.We quantified the abundance of the FL-MMP-2 and NTT-MMP-2 transcripts by qPCR in HK2 cells cultured in high glucose or 4-hydroxy-2-hexenal (HHE and tested the effects of the NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC. The streptozotocin (STZ murine model of Type I diabetes mellitus and renal biopsies of human diabetic nephropathy were used in this study.Both isoforms of MMP-2 in HK2 cells were upregulated by culture in high glucose or with HHE. PDTC treatment did not suppress high glucose-mediated FL-MMP-2 expression but potently inhibited NTT-MMP-2 expression. With STZ-treated mice, renal cortical expression of both isoforms was increased (FL-MMP-2, 1.8-fold; NTT-MMP-2, greater than 7-fold. Isoform-specific immunohistochemical staining revealed low, but detectable levels of the FL-MMP-2 isoform in controls, while NTT-MMP-2 was not detected. While there was a modest increase in tubular epithelial cell staining for FL-MMP-2 in STZ-treated mice, NTT-MMP-2 was intensely expressed in a basolateral pattern. FL-MMP-2 and NTT-MMP-2 isoform expression as quantified by qPCR were both significantly elevated in renal biopsies of human diabetic nephropathy (12-fold and 3-fold, respectively.The expression of both isoforms of MMP-2 was enhanced in an experimental model of diabetic nephropathy and in human diabetic nephropathy. Selective MMP-2 isoform inhibition could offer a novel approach for the treatment of diabetic renal

  2. Impact of the Group Lifestyle Balance (GLB) Program on Diabetes Prevention in the Military Health System

    Science.gov (United States)

    2016-05-20

    syndrome . Adults~ 1 Byrs with a BMI ~ 25 kg/m2, prediabetes, or metabolic syndrome (metS) were primary care provider and self-referred to GLB. Classes...prevalence: prediabetes 90.6%, obesity 56.1 %, and metabolic syndrome 33.3%. Change from baseline was compared at the end of 12 weeks. Overall, 52% of all... metabolic syndrome . Factors to improve GLB completion rates are currently under active investigation . Additional long- term studies regarding diabetes

  3. Mediastinal, subcutaneous and multiple muscular abscesses caused by group B streptococcus serotype VIII in a type 2 diabetes mellitus patient.

    Science.gov (United States)

    Omura, Yuka; Kusama, Yoshiki; Takeuchi, Noriko; Ishiwada, Naruhiko

    2018-01-17

    We report a case of mediastinal subcutaneous and multiple muscular abscesses caused by group B streptococcus serotype VIII in a type 2 diabetes mellitus patient. The patient arrived at the hospital with the chief complaint of immobility, and blood examination results suggested an acute infection and poorly controlled diabetes mellitus. Group B streptococcal bacteria were cultured from the patient's blood, and identified as serotype VIII upon further analysis. The patient recovered without any sequelae after percutaneous drainage, antibiotic therapy, and intensive glycemic control. Although the incidence of group B streptococcal infection in non-pregnant adults has recently increased in many developed countries, information on serotype VIII infection is quite limited. The reason is that serotype VIII group B streptococci are a Japan-specific serotype, and rarely cause invasive infections, even in Japan. Therefore, further surveillance and case reports should be documented in the future. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  4. The effects of implementing the International Association of Diabetes and Pregnancy Study Groups criteria for diagnosing gestational diabetes on maternal and neonatal outcomes.

    Directory of Open Access Journals (Sweden)

    Tai-Ho Hung

    Full Text Available In 2010, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG recommended a new strategy for the screening and diagnosis of gestational diabetes mellitus (GDM. However, no study has indicated that adopting the IADPSG recommendations improves perinatal outcomes. The objective of this study was to evaluate the effects of implementing the IADPSG criteria for diagnosing GDM on maternal and neonatal outcomes.Previously, we used a two-step approach (a 1-h, 50-g glucose challenge test followed by a 3-h, 100-g glucose tolerance test when indicated to screen for and diagnose GDM. In July 2011, we adopted the IADPSG recommendations in our routine obstetric care. In this study, we retrospectively compared the rates of various maternal and neonatal outcomes in all women who delivered after 24 weeks of gestation during the periods before (P1, between January 1, 2009 and December 31, 2010 and after (P2, between January 1, 2012 and December 31, 2013 the IADPSG criteria were implemented. Pregnancies complicated by multiple gestations, fetal chromosomal or structural anomalies, and pre-pregnancy diabetes mellitus were excluded. Our results showed that the incidence of GDM increased from 4.6% using the two-step method to 12.4% using the IADPSG criteria. Compared to the women in P1, the women in P2 experienced less weight gain during pregnancy, lower birth weights, shorter labor courses, and lower rates of macrosomia (<4000 g and large-for-gestational age (LGA infants. P2 was a significant independent factor against macrosomia (adjusted odds ratio [OR] 0.63, 95% confidence interval [CI] 0.43-0.90 and LGA (adjusted OR 0.74, 95% CI 0.61-0.89 after multivariable logistic regression analysis.The adoption of the IADPSG criteria for diagnosis of GDM was associated with significant reductions in maternal weight gain during pregnancy, birth weights, and the rates of macrosomia and LGA.

  5. The AMIGO Clinical Study: Attrition Rates Among Military Beneficiaries Undergoing Intensive Group Outpatient Pre-Diabetes Care

    Science.gov (United States)

    2013-11-11

    type 2 diabetes mellitus in U.S. Air Force personnel. Journal of Diabetes Science and Technology. (2009); 3(4): 770-775. 5. Kramer, K... 2 diabetes . Diabetes Care. (2001); 24(11): 1894-1898. 4. Lott, L. A genomics study of type 2 diabetes mellitus in U.S. Air Force personnel...military populations report incidence of all types of diabetes reflects that seen in the civilian sector, approximately 2 cases per

  6. A group exercise programme for people at risk from type II diabetes run as a physiotherapy student clinical placement is beneficial: a qualitative study

    National Research Council Canada - National Science Library

    van Bysterveldt, Erin; Davey, Simon; Douglas, Naomi; Liu, Robert; Robertson, Linda; Conroy, Jenny; Higgs, Chris; Hale, Leigh

    2014-01-01

    ... for undergraduate physiotherapy students. Class participants included 10 adults with, or at high risk of developing, type II diabetes and 3 family members attending a 12-week group exercise programme and 20 supervised undergraduate physio...

  7. Diabetes mellitus and abnormal glucose tolerance development after gestational diabetes: A three-year, prospective, randomized, clinical-based, Mediterranean lifestyle interventional study with parallel groups.

    Science.gov (United States)

    Pérez-Ferre, Natalia; Del Valle, Laura; Torrejón, Maria José; Barca, Idoya; Calvo, María Isabel; Matía, Pilar; Rubio, Miguel A; Calle-Pascual, Alfonso L

    2015-08-01

    Women with prior gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes mellitus (DM2) in later life. The study aim was to evaluate the efficacy of a lifestyle intervention for the prevention of glucose disorders (impaired fasting glucose, impaired glucose tolerance or DM2) in women with prior GDM. A total of 260 women with prior GDM who presented with normal fasting plasma glucose at six to twelve weeks postpartum were randomized into two groups: a Mediterranean lifestyle intervention group (n = 130) who underwent an educational program on nutrition and a monitored physical activity program and a control group (n = 130) with a conventional follow-up. A total of 237 women completed the three-year follow-up (126 in the intervention group and 111 in the control group). Their glucose disorders rates, clinical and metabolic changes and rates of adherence to the Mediterranean lifestyle were analyzed. Less women in the intervention group (42.8%) developed glucose disorders at the end of the three-year follow-up period compared with the control group (56.75%), p < 0.05. The multivariate analysis indicated a reduction in the rate of glucose disorders with a BMI of less than 27 kg/m(2) (OR 0.28; 0.12-0.65; p < 0.003), low fat intake pattern (OR 0.30; 0.13-0.70; p < 0.005), low saturated fat pattern (OR 0.30; 0.13-0.69; p < 0.005) and healthy fat pattern (OR 0.34; 0.12-0.94; p < 0.04). Lifestyle intervention was effective for the prevention of glucose disorders in women with prior GDM. Body weight gain and an unhealthy fat intake pattern were found to be the most predictive factors for the development of glucose disorders. Current Controlled trials: ISRCTN24165302. http://www.controlled-trials.com/isrctn/pf/24165302. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Pathophysiological characteristics and effects of obesity in women with early and late manifestation of gestational diabetes diagnosed by the International Association of Diabetes and Pregnancy Study Groups criteria.

    Science.gov (United States)

    Bozkurt, Latife; Göbl, Christian S; Pfligl, Lisa; Leitner, Karoline; Bancher-Todesca, Dagmar; Luger, Anton; Baumgartner-Parzer, Sabina; Pacini, Giovanni; Kautzky-Willer, Alexandra

    2015-03-01

    Appropriate risk stratification is essential in gestational diabetes (GDM) diagnosis to optimize therapeutic strategies during pregnancy. However, there are sparse data related to the newly recommended International Association of Diabetes and Pregnancy Study Groups criteria and their use in early pregnancy. This study sought to evaluate clinical and pathophysiological characteristics less up to gestational week (GW) 21 in women with early and late GDM onset. This was a prospective study conducted at the Medical University of Vienna. Pregnant women (n = 211) underwent an oral glucose tolerance test at 16 GW (interquartile range, 14-18 wk) with multiple measurements of glucose, insulin, and C-peptide for evaluation of insulin sensitivity and ß-cell function in addition to detailed obstetrical risk assessment. Clinical followups were performed until end of pregnancy. We performed a metabolic characterization of early-onset GDM. Of 81 women, 49 (23%) showed early (GDMEarly ≤ 21 GW) and 32 (15%) later manifestation (GDMLate ≥ 24 GW) whereas 130 (62%) remained normal-glucose-tolerant (NGT). In contrast with GDMLate, GDMEarly were affected by decreased insulin sensitivity (GDMEarly vs NGT, P obesity. However, ß-cell dysfunction was also detectable in GDMLate, indicating defective compensatory mechanisms emerging already in early pregnancy.

  9. Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria.

    Science.gov (United States)

    Huhn, Evelyn A; Massaro, Nadine; Streckeisen, Simone; Manegold-Brauer, Gwendolin; Schoetzau, Andreas; Schulzke, Sven M; Winzeler, Bettina; Hoesli, Irene; Lapaire, Olav

    2017-04-01

    The aim was to evaluate the influence of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines for screening of gestational diabetes mellitus (GDM) on GDM prevalence in a cohort from a Swiss tertiary hospital. This was a retrospective cohort study involving all pregnant women who were screened for GDM between 24 and 28 weeks of gestation. From 2008 until 2010 (period 1), a two-step approach with 1-h 50 g glucose challenge test (GCT) was used, followed by fasting, 1- and 2-h glucose measurements after a 75 g oral glucose tolerance test (OGTT) in case of a positive GCT. From 2010 until 2013 (period 2), all pregnant women were tested with a one-step 75 g OGTT according to new IADPSG guidelines. In both periods, women with risk factors could be screened directly with a 75 g OGTT in early pregnancy. Overall, 647 women were eligible for the study in period 1 and 720 in period 2. The introduction of the IADPSG criteria resulted in an absolute increase of GDM prevalence of 8.5% (3.3% in period 1 to 11.8% in period 2). The adoption of the IADPSG criteria resulted in a considerable increase in GDM diagnosis in our Swiss cohort. Further studies are needed to investigate if the screening is cost effective and if treatment of our additionally diagnosed GDM mothers might improve short-term as well as long-term outcome.

  10. Hypoglycemic effect of methanolic extract of Musa paradisiaca (Musaceae) green fruits in normal and diabetic mice.

    Science.gov (United States)

    Ojewole, J A O; Adewunmi, C O

    2003-01-01

    Diabetes mellitus is a debilitating hormonal disorder in which strict glycemic control and prevention of associated complications are of crucial importance. This study was designed to evaluate the hypoglycemic effect of methanolic extract of mature, green fruits of Musa paradisiaca (MEMP) in normal (normoglycemic) and streptozotocin (STZ)-treated, diabetic (hyperglycemic) mice, using chlorpropamide as the reference antidiabetic agent. MEMP (100-800 mg/kg p.o.) induced significant, dose-related (p < 0.05-0.001) reductions in the blood glucose concentrations of both normal and diabetic mice. Chlorpropamide (250 mg/kg p.o.) also produced significant (p < 0.01-0.001) reductions in the blood glucose concentrations of normal and diabetic mice. The results of this experimental study indicate that, in the mammalian model used, MEMP possesses hypoglycemic activity. Although the precise mechanism of the hypoglycemic action of MEMP is still unclear and will have to await further studies, it could be due, at least in part, to stimulation of insulin production and subsequent glucose utilization. Nevertheless, the findings of this experimental animal study indicate that MEMP possesses hypoglycemic activity, and thus lends credence to the suggested folkloric use of the plant in the management and/or control of adult-onset, type-2 diabetic mellitus among the Yoruba-speaking people of South-Western Nigeria.

  11. Higher plasma high-mobility group box 1 levels are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes

    DEFF Research Database (Denmark)

    Nin, J W M; Ferreira, I; Schalkwijk, C G

    2012-01-01

    This study aimed to investigate the associations of plasma levels of the pro-inflammatory cytokine high-mobility group box 1 (HMGB1) with incident cardiovascular disease (CVD) and all-cause mortality in patients with type 1 diabetes.......This study aimed to investigate the associations of plasma levels of the pro-inflammatory cytokine high-mobility group box 1 (HMGB1) with incident cardiovascular disease (CVD) and all-cause mortality in patients with type 1 diabetes....

  12. [Prevalence of obesity and cardiovascular risk factors in a group of paediatric patients with type 1 diabetes].

    Science.gov (United States)

    Palomo Atance, E; Giralt Muiña, P; Ballester Herrera, M J; Ruiz Cano, R; León Martín, A; Giralt Muiña, J

    2013-06-01

    To establish the prevalence of overweight-obesity and metabolic syndrome in a group of paediatric patients with type 1 diabetes (DM1), and to determine the effects on the lipoprotein profile and metabolic control. A group of 115 patients (5-16 years) with DM1, and on intensive insulin therapy was studied. Weight, height, body mass index (BMI), waist circumference (WC), blood pressure (BP), glycosylated haemoglobin (HbA1c), total cholesterol (TC), HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c) and triglycerides (TG) were measured. The results were stratified by sex and age (obesity (according to Hernández's reference values) was 28.69% and 18.26%, respectively, with female predominance in both cases. The prevalence of metabolic syndrome (according to the International Diabetes Federation criteria) was 3.22%. 3.47% The WC adjusted for age and sex was > 90th percentile in 3.47% of cases, and 2.6% had a systolic BP ≥ 130 mmHg and/or a diastolic BP ≥ 85 mmHg. An HDL-c Obese patients had lower HDL-c levels and higher LDL-c levels than non-obese subjects. There were no significant differences in HbA1c between patients with overweight-obesity and the rest. Overweight and obesity are common in paediatric patients with DM1. Nevertheless, the prevalence of metabolic syndrome and cardiovascular risk factors is lower than in adult patients. The group of diabetic children with obesity had a lipoprotein profile of cardiovascular risk. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier España, S.L. All rights reserved.

  13. Cognitive-behavioral group therapy for depression in adolescents with diabetes: a pilot study

    OpenAIRE

    Jeannette M. Rosselló; María I. Jiménez-Chafey

    2006-01-01

    El propósito de este estudio es adaptar y hacer un estudio piloto de una intervención de Terapia Cognitivo-Conductual (TCC) grupal que ha sido efectivo en tratar la depresión en adolescentes puertorriqueños/as, para tratar los sintomatología depresiva y mejorar el control glucémico en adolescentes con diabetes. Once adolescentes entre las edades de 13 y 16 participaron en 12 sesiones de la intervención. Indicadores de los efectos de la intervención (sintomatología depresiva y ansi...

  14. Oral health status in 5-18 years old children and adolescent with type 1 diabetes compared with healthy group in Hamadan, Iran 2013-2014

    Directory of Open Access Journals (Sweden)

    Rezvan Rafatjou

    2016-11-01

    Full Text Available Background and Aims: Type 1 diabetes mellitus, is the most common metabolic disorders in children and adolescents. The aim of this study was to assess the state of oral health in children with type 1 diabetes compared with healthy children in 2013-2014 in Hamadan province, Iran. Materials and Methods: The specimens were selected through convenience sampling in two groups. Group one consisted of 80 individuals (5-18 years old; case group, suffering from type 1 diabetes mellitus referred to the Pediatric endocrine clinic. Control group consisted of 80 non-diabetic healthy children who were out- patients of pediatric and orthodontic department of Hamadan dental school. Two groups were similar in age and sex. The data were collected through a questionnaire, medical records and clinical examination. DMFT, dmft, GI and PI indices were assessed in each patient. Data were analyzed using ANOVA and T-test. Results: In spite of similarity in oral hygiene habits in both group, there was no significant difference in mean DMFT and permanent decayed teeth in both groups (P>0.05, but the mean dmft (P<0.008 and primary decayed teeth (P<0.011 in the control group was significantly higher than that of the case group. Also, diabetic patients had significantly more gingival inflammation (P<0.05. The mean PI in the two groups did not differ significantly. Oral hygiene habits were similar in both groups but diabetic patients were significantly referred to dentists with lower frequency then that of control group (P=0.00. Conclusion: The devastating effects of diabetes on the oral health, along with other side effects can be effective in promoting tooth decay and gingivitis in diabetic patients. Unfortunately, oral health care and programmed dental visit were not the priority for the diabetic patient (and parents involved in our study. Therefore, programs to increase awareness and encourage patients for a better control of their oral health in order to diminish diabetes

  15. Evaluation of 75 g glucose load in non-fasting state [Diabetes in Pregnancy Study group of India (DIPSI) criteria] as a diagnostic test for gestational diabetes mellitus.

    Science.gov (United States)

    Tripathi, Reva; Verma, Divya; Gupta, Vinod Kumar; Tyagi, Shakun; Kalaivani, M; Ramji, Siddarth; Mala, Y M

    2017-02-01

    There is no consensus regarding optimal standard for diagnosis of gestational diabetes mellitus (GDM). In this study, use of 75 g glucose load in non-fasting state [Diabetes in Pregnancy Study Group of India (DIPSI) criteria] as a diagnostic test for GDM in pregnant women was compared with different oral glucose tolerance tests (OGTTs). This prospective study included 936 pregnant women, who underwent plasma glucose evaluation two hours after the challenge of 75 g glucose load irrespective of the timing of last meal (DIPSI criteria for GDM). After three days, standard 75 g OGTT was done in all women irrespective of previous plasma glucose value. Accuracy of the first result was compared to OGTT using cut-offs as per the World Health Organization (WHO) and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for the diagnosis of GDM. Of the total 936 pregnant women, 73 (7.8%) patients had plasma glucose value ≥140 mg/dl when measured two hours after glucose load. When comparing with the WHO and IADPSG criteria, the sensitivity values were 65.1 and 74.1 per cent, respectively, and the corresponding specificity values were 96.3 and 96.9 per cent, respectively. On comparing with the WHO OGTT, only 41 of the 73 (56.2%) were true positives, whereas when IADPSG criteria were used, true positives were 46 (63%). False negative cases were also present when classified by the WHO and IADPSG criteria though in lesser numbers than false positives. The positive predictive values (PPVs) for the WHO and IADPSG criteria were 56.1 and 63 per cent, respectively, and their corresponding negative predictive values were 97.7 and 97.9 per cent, respectively. Our findings showed that when 75 g glucose load in non-fasting state was used as a diagnostic test for GDM, almost one quarter of patients with GDM escaped diagnosis as sensitivity values were low. On the other hand, some GDM cases were falsely labelled as normal as this test did not account for cases

  16. The Effect of Group Discussion-based Education on Self-management of Adults with Type 2 Diabetes Mellitus Compared with Usual Care: A Randomized Control Trial.

    Science.gov (United States)

    Habibzadeh, Hosein; Sofiani, Akbar; Alilu, Leyla; Gillespie, Mark

    2017-11-01

    We sought to determine the effect of group discussion-based education on the self-management capability of patients with type 2 diabetes in Iran. This randomized control trial was conducted on 90 patients with type 2 diabetes. Participants were allocated randomly into one of two groups; intervention and control. The intervention group received the group discussion-based education while the control group received routine care only. The Lin's self-management questionnaire was completed at baseline and three months post-intervention. Statistical analysis, including the use of independent t-test, identified that in comparison to the control group, significant increases were observed in the scores of self-organization (t =11.24, p self-adjustment (t = 7.53, p self-monitoring (t = 6.42, p self-management (t = 10.82, p self-manage diabetes.

  17. The effectiveness of group medical visits on diabetes mellitus type 2 (dm2) specific outcomes in adults: a systematic review.

    Science.gov (United States)

    Burke, Robert E; Ferrara, Stephen A; Fuller, Alisha M; Kelderhouse, Jacqueline M; Ferrara, Lucille R

    2011-01-01

    The prevalence of diabetes mellitus is ubiquitous. Complications and costs of diabetes are rising and are depleting limited resources. It is imperative for healthcare professionals and patients alike to confront this chronic condition by exploring new interventions. An innovative health care delivery model has emerged in the last 25 years in the form of the group medical visit. Group medical visits can range from of six to twenty patients scheduled together with time allotted for individual care as well as in the group setting. The review objective was to conduct a systematic review and meta-analysis to synthesize the best available evidence related to effectiveness of group medical visits on HbA1c, blood pressure and cholesterol measurements/levels for adult patients with type II diabetes in outpatient settings. A three-step literature search for studies in English language from 1990 to 2010 was conducted utilising (a) a primary search of Medline, CINAHL, PsycINFO and Cochrane Central Register of Controlled Trials, (b) a secondary search of non-indexed databases, and (c) a search of the grey literature. In addition, a manual review of the reference lists of all identified reports and articles was performed to identify additional studies. All randomised and quasi-experimental studies of adult patients (>18) with type II diabetes mellitus seen in outpatient health settings were considered if they met one or more of the following diagnostic outcome measurements: haemoglobin A1c, systolic and diastolic blood pressure, and low density lipoprotein cholesterol. Each of the eligible articles was reviewed by two independent reviewers. Disagreements between the reviewers were resolved through discussion, or with a third reviewer. Studies that met the inclusion criteria were assessed for methodological quality using the JBI standardized critical appraisal tools. Data extraction was undertaken using the standardised data extraction tool from JBI-MAStARI. The search strategy

  18. Using the Johns Hopkins' Aggregated Diagnosis Groups (ADGs) to predict 1-year mortality in population-based cohorts of patients with diabetes in Ontario, Canada.

    Science.gov (United States)

    Austin, P C; Shah, B R; Newman, A; Anderson, G M

    2012-09-01

    There are limited validated methods to ascertain comorbidities for risk adjustment in ambulatory populations of patients with diabetes using administrative health-care databases. The objective was to examine the ability of the Johns Hopkins' Aggregated Diagnosis Groups to predict mortality in population-based ambulatory samples of both incident and prevalent subjects with diabetes. Retrospective cohorts constructed using population-based administrative data. The incident cohort consisted of all 346,297 subjects diagnosed with diabetes between 1 April 2004 and 31 March 2008. The prevalent cohort consisted of all 879,849 subjects with pre-existing diabetes on 1 January, 2007. The outcome was death within 1 year of the subject's index date. A logistic regression model consisting of age, sex and indicator variables for 22 of the 32 Johns Hopkins' Aggregated Diagnosis Group categories had excellent discrimination for predicting mortality in incident diabetes patients: the c-statistic was 0.87 in an independent validation sample. A similar model had excellent discrimination for predicting mortality in prevalent diabetes patients: the c-statistic was 0.84 in an independent validation sample. Both models demonstrated very good calibration, denoting good agreement between observed and predicted mortality across the range of predicted mortality in which the large majority of subjects lay. For comparative purposes, regression models incorporating the Charlson comorbidity index, age and sex, age and sex, and age alone had poorer discrimination than the model that incorporated the Johns Hopkins' Aggregated Diagnosis Groups. Logistical regression models using age, sex and the John Hopkins' Aggregated Diagnosis Groups were able to accurately predict 1-year mortality in population-based samples of patients with diabetes. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  19. SOCIAL PARTICIPATION OF DIABETES AND EX-LEPROSY PATIENTS IN THE NETHERLANDS AND PATIENT PREFERENCE FOR COMBINED SELF-CARE GROUPS

    Directory of Open Access Journals (Sweden)

    Henry John Christiaan De Vries

    2014-08-01

    Full Text Available Introduction: Earlier we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients a self-care group exclusively for (exleprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants.Methods: Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes towards combined self-care groups for diabetic patients with neuropathy.Results: The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did

  20. Gestational Diabetes Mellitus in Korean Women: Similarities and Differences from Other Racial/Ethnic Groups

    Directory of Open Access Journals (Sweden)

    Catherine Kim

    2014-02-01

    Full Text Available Gestational diabetes mellitus (GDM reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.

  1. Impact of ethnicity on gestational diabetes identified with the WHO and the modified International Association of Diabetes and Pregnancy Study Groups criteria: a population-based cohort study.

    Science.gov (United States)

    Jenum, Anne K; Mørkrid, Kjersti; Sletner, Line; Vangen, Siri; Vange, Siri; Torper, Johan L; Nakstad, Britt; Voldner, Nanna; Rognerud-Jensen, Odd H; Berntsen, Sveinung; Mosdøl, Annhild; Skrivarhaug, Torild; Vårdal, Mari H; Holme, Ingar; Yajnik, Chittaranjan S; Birkeland, Kåre I

    2012-02-01

    The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recently proposed new criteria for diagnosing gestational diabetes mellitus (GDM). We compared prevalence rates, risk factors, and the effect of ethnicity using the World Health Organization (WHO) and modified IADPSG criteria. This was a population-based cohort study of 823 (74% of eligible) healthy pregnant women, of whom 59% were from ethnic minorities. Universal screening was performed at 28±2 weeks of gestation with the 75 g oral glucose tolerance test (OGTT). Venous plasma glucose (PG) was measured on site. GDM was diagnosed as per the definition of WHO criteria as fasting PG (FPG) ≥7.0 or 2-h PG ≥7.8 mmol/l; and as per the modified IADPSG criteria as FPG ≥5.1 or 2-h PG ≥8.5 mmol/l. OGTT was performed in 759 women. Crude GDM prevalence was 13.0% with WHO (Western Europeans 11%, ethnic minorities 15%, P=0.14) and 31.5% with modified IADPSG criteria (Western Europeans 24%, ethnic minorities 37%, P< 0.001). Using the WHO criteria, ethnic minority origin was an independent predictor (South Asians, odds ratio (OR) 2.24 (95% confidence interval (CI) 1.26-3.97); Middle Easterners, OR 2.13 (1.12-4.08)) after adjustments for age, parity, and prepregnant body mass index (BMI). This increased OR was unapparent after further adjustments for body height (proxy for early life socioeconomic status), education and family history of diabetes. Using the modified IADPSG criteria, prepregnant BMI (1.09 (1.05-1.13)) and ethnic minority origin (South Asians, 2.54 (1.56-4.13)) were independent predictors, while education, body height and family history had little impact. GDM prevalence was overall 2.4-times higher with the modified IADPSG criteria compared with the WHO criteria. The new criteria identified many subjects with a relatively mild increase in FPG, strongly associated with South Asian origin and prepregnant overweight.

  2. Perceived benefits, barriers, and strategies of family meals among children with type 1 diabetes mellitus and their parents: focus-group findings.

    Science.gov (United States)

    Rovner, Alisha J; Mehta, Sanjeev N; Haynie, Denise L; Robinson, Elizabeth M; Pound, Heidi J; Butler, Deborah A; Laffel, Lori M; Nansel, Tonja R

    2010-09-01

    Dietary management of type 1 diabetes mellitus has become much less restrictive and more flexible in recent years due to contemporary insulin regimens, which may afford families of children with type 1 diabetes mellitus greater ease in sharing family meals. Although these treatment advancements might facilitate family meals, overall demands of diabetes management can influence family's perceived or actual ability to do so. Youths with type 1 diabetes mellitus (ages 8 to 20 years) and parents participated in separate focus groups. Thirty-five youths with type 1 diabetes mellitus (mean age=15.1+/-3.6 years) and their parents participated in 21 focus groups (12 youth groups, nine parent groups). Although there was substantial variability in how often family meals occurred, both parents and youths consistently perceived family meals as valuable and enjoyable. The major barrier to family meals discussed by both youths and parents was busy schedules. Strategies for having family meals that were discussed by parents included shopping to ensure availability of the foods needed to prepare meals, planning, and cooking meals in advance, and using simplified cooking methods. These findings suggest that a family-focused approach to nutrition interventions in this population, as opposed to one targeting the child with diabetes only, can improve the chance for successful dietary change. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  3. Health-related quality of life in people with type 1 Diabetes Mellitus: data from the Brazilian Type 1 Diabetes Study Group.

    Science.gov (United States)

    Braga de Souza, Ana Carolina Contente; Felício, João Soares; Koury, Camila Cavalcante; Neto, João Felício Abrahão; Miléo, Karem Barbosa; Santos, Flávia Marques; Negrato, Carlos Antonio; Motta, Ana Regina Bastos; Silva, Denisson Dias; Arbage, Thaís Pontes; Carvalho, Carolina Tavares; de Rider Brito, Hana Andrade; Yamada, Elizabeth Sumi; Cunha de Melo, Franciane Trindade; Resende, Fabricio de Souza; Ferreira, Juliana Cristina Cardoso; Gomes, Marilia Brito

    2015-12-24

    Type 1 Diabetes Mellitus (Type 1 DM) affects the psychological and emotional well-being of patients and their families. This study aims to evaluate the health- related quality of life (HRQoL) of people with Type 1 DM in Brazil, a country of continental proportions, using the EuroQol questionnaires. This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group, by analyzing EuroQol scores from 3,005 participants with Type 1 DM, in 28 public clinics in Brazil. Data on demography, economical status, chronic complications, glycemic control and lipid profile were also collected. The assessment of HRQoL by the EuroQol showed that the average score assigned to general health in Brazil is markedly lower than those found in two other Type 1 DM population-based studies conducted in Europe (EQ-VAS from the Netherlands, the United Kingdom and Brazil were 80.8 ± 15.2, 75.1 ± 18.4 and 72.5 ± 22, respectively). Additionally, our data suggest that a better glycemic control could positively impact the HRQoL of people with Type 1 DM, implying that each 1 % reduction in glycated haemoglobin might lead to an increase of 1.5 points in general health status assessed by the EuroQol. This is a population-based study evaluating the HRQoL of people with Type 1 DM in Brazil. Our data indicate a worse quality of health of people with Type 1 DM in Brazil in comparison to Europe, and suggest that a better glycemic control could positively impact the HRQoL of these individuals. However, this study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of these people.

  4. Pathophysiological Characteristics and Effects of Obesity in Women With Early and Late Manifestation of Gestational Diabetes Diagnosed by the International Association of Diabetes and Pregnancy Study Groups Criteria

    Science.gov (United States)

    Bozkurt, Latife; Göbl, Christian S.; Pfligl, Lisa; Leitner, Karoline; Bancher-Todesca, Dagmar; Luger, Anton; Baumgartner-Parzer, Sabina; Pacini, Giovanni

    2015-01-01

    Context: Appropriate risk stratification is essential in gestational diabetes (GDM) diagnosis to optimize therapeutic strategies during pregnancy. However, there are sparse data related to the newly recommended International Association of Diabetes and Pregnancy Study Groups criteria and their use in early pregnancy. Objective: This study sought to evaluate clinical and pathophysiological characteristics less up to gestational week (GW) 21 in women with early and late GDM onset. Design and Setting: This was a prospective study conducted at the Medical University of Vienna. Patients and Interventions: Pregnant women (n = 211) underwent an oral glucose tolerance test at 16 GW (interquartile range, 14–18 wk) with multiple measurements of glucose, insulin, and C-peptide for evaluation of insulin sensitivity and ß-cell function in addition to detailed obstetrical risk assessment. Clinical followups were performed until end of pregnancy. Main outcome measure: We performed a metabolic characterization of early-onset GDM. Results: Of 81 women, 49 (23%) showed early (GDMEarly ≤ 21 GW) and 32 (15%) later manifestation (GDMLate ≥ 24 GW) whereas 130 (62%) remained normal-glucose-tolerant (NGT). In contrast with GDMLate, GDMEarly were affected by decreased insulin sensitivity (GDMEarly vs NGT, P manifested subjects showed impairments in ß-cell function. GDMEarly showed highest levels of preconceptional and actual body mass index (BMI), which was related to fasting glucose (r = 0.42, P manifestation of GDM is affected by insulin resistance that is partly explained by higher degree in obesity. However, ß-cell dysfunction was also detectable in GDMLate, indicating defective compensatory mechanisms emerging already in early pregnancy. PMID:25574889

  5. Gestational diabetes and pregnancy outcomes - a systematic review of the World Health Organization (WHO and the International Association of Diabetes in Pregnancy Study Groups (IADPSG diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Wendland Eliana M

    2012-03-01

    Full Text Available Abstract Background Two criteria based on a 2 h 75 g OGTT are being used for the diagnosis of gestational diabetes (GDM, those recommended over the years by the World Health Organization (WHO, and those recently recommended by the International Association for Diabetes in Pregnancy Study Group (IADPSG, the latter generated in the HAPO study and based on pregnancy outcomes. Our aim is to systematically review the evidence for the associations between GDM (according to these criteria and adverse outcomes. Methods We searched relevant studies in MEDLINE, EMBASE, LILACS, the Cochrane Library, CINHAL, WHO-Afro library, IMSEAR, EMCAT, IMEMR and WPRIM. We included cohort studies permitting the evaluation of GDM diagnosed by WHO and or IADPSG criteria against adverse maternal and perinatal outcomes in untreated women. Only studies with universal application of a 75 g OGTT were included. Relative risks (RRs and their 95% confidence intervals (CI were obtained for each study. We combined study results using a random-effects model. Inconsistency across studies was defined by an inconsistency index (I2 > 50%. Results Data were extracted from eight studies, totaling 44,829 women. Greater risk of adverse outcomes was observed for both diagnostic criteria. When using the WHO criteria, consistent associations were seen for macrosomia (RR = 1.81; 95%CI 1.47-2.22; p 2 ≥ 73%. Magnitudes of RRs and their 95%CIs were 1.73 (1.28-2.35; p = 0.001 for large for gestational age; 1.71 (1.38-2.13; p Conclusions The WHO and the IADPSG criteria for GDM identified women at a small increased risk for adverse pregnancy outcomes. Associations were of similar magnitude for both criteria. However, high inconsistency was seen for those with the IADPSG criteria. Full evaluation of the latter in settings other than HAPO requires additional studies.

  6. The Effect of Group Discussion on the Quality of Life and HbA1c Levels of Adolescents With Diabetes.

    Science.gov (United States)

    Afshar, Mohamad; Memarian, Robabe; Mohammadi, Esa

    2014-08-01

    Diabetes is a metabolic syndrome and the most common endocrine disorder in childhood and adolescence. Diabetes occurs at any age but the highest outbreak is during ten to 15 years of age and 75% of the cases are diagnosed at the age 18. This study aimed to investigate the effect of a group discussion on the quality of life (QOL) and glycosylated hemoglobin A (HbA1c) levels of adolescents with diabetes. This quasi-experimental study was performed on 56 adolescents with diabetes who were referred to Golabchi Diabetes Center in Kashan, Iran. After obtaining written informed consent from the patients, blood sample was drawn for measuring sugar and HbA1c levels. The participants completed the questionnaire regarding the QOL. Patients were randomly allocated to four groups. All the groups attended similar group discussion sessions, which were conducted according to the guidance of diabetic specialists. The groups' members followed the discussed instructions for four months. Then, another questionnaire was completed and blood sugar and HbA1c levels were measured again. The results were compared by paired-samples t-test and Wilcoxon signed-rank test. After the group discussion sessions, in 56% of the patients the HbA1c levels (8.45 ± 1.35 and 6.98 ± 0.89 before and after intervention, respectively) and QOL were improved significantly. The mean age of these patients was 14.75 ± 1.80 years and the mean of daily insulin injection was 35.70 ± 13.42 units. Sharing experiences trough group discussions and receiving instructive feedbacks can improve the QOL and metabolic status of adolescents with diabetes.

  7. [Type 2 diabetes and universal health care for low-income groups: a case-control study].

    Science.gov (United States)

    Barnichon, C; Ruivard, M; Philippe, P; Vidal, P; Teissonière, M

    2011-08-01

    In 2007 in France, type 2 diabetes involved 2.5 million people, and 4.5 million patients received free healthcare coverage under the universal healthcare coverage program (CMU) for low-income households. An optimal glycemic control and adequate diabetes monitoring can reduce the incidence of complications. The objective of this study was to compare the diabetes care of low-income patients (as defined by CMU coverage) with the rest of the population. A retrospective case-control study (non-CMU and CMU) over a one-year period of glycemic control for both populations through private laboratory data (number and values of HbA1c) and of individuals monitoring through data from the regional health insurance public institute. Regarding glycemic control, 154 patients were included. The number of annual HbA1c tests was similar between CMU and non-CMU patients. The mean HbA1c value was higher for CMU patients (8.7% versus 8%; P<0.01). Regarding monitoring, 1254 patients were included. Over a one-year period, the number of HbA1c tests, lipid profile tests, serum creatinine measures and cardiology consultations were similar across groups. However, CMU patients benefited from less microalbuminuria testing (P<0.001), ophthalmologic monitoring visits (P<0.01), endocrinology consultations (P<0.01), and from more general physician consultations (P<0.001). Receiving CMU health coverage was associated with a poorer glycemic control and lesser specialized monitoring than that was observed in control patients. Across the population, follow-up recommendations are far from being implemented satisfactorily. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  8. Role of iNOS and eNOS expression in a group of Egyptian diabetic and nondiabetic nephropathy patients

    Directory of Open Access Journals (Sweden)

    Mayssa I. Aly

    2013-01-01

    Conclusion The presence of iNOS is associated with tubular damage resulting in renal failure. The upregulation of NO in diabetes mellitus type 2 may explain the endothelial dysfunction that is associated with almost all diabetic complications.

  9. Supervised group-exercise therapy versus home-based exercise therapy: Their effects on Quality of Life and cardiovascular risk factors in women with type 2 diabetes.

    Science.gov (United States)

    Dadgostar, Haleh; Firouzinezhad, Sahar; Ansari, Majid; Younespour, Shima; Mahmoudpour, Azam; Khamseh, Mohammad Ebrahim

    2016-01-01

    Exercise is an integral part of diabetes care. In Iranian women with type II diabetes, we compared the effects of supervised group exercise therapy with the effects of home-based exercise therapy on health-related quality of life (HRQOL), anthropometric parameters, glycaemic control and lipid profile. One hundred and two diabetic women were randomised to supervised and home-based groups. Over 12 weeks, participants received supervised group-exercise therapy or a home-based exercise-therapy program. During the intervention, they were assessed three times: at baseline, and at weeks 6 and 12. Generalized Estimating Equation models were used to examine the associations between the type of exercise-therapy program and changes over time in anthropometric and biochemical outcomes, and in HRQOL scales of SF36 questionnaire. Relative to home-based group, supervised group improved significantly regarding role-physical, general health, mean body weight and body mass index from baseline to week 12 (p=0.01). Their reduction in mean body-fat mass from baseline to week 6 (p=0.04) was greater. Similarly, their role-physical, general health and role-emotional improved significantly during the intervention (pwomen. However, home-based exercise therapy also produced significant improvements in glycaemic control, body composition and lipid profile. Whether in a supervised or home-based setting, the exercise intervention can therefore be effective in improving health outcomes in diabetic patients. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  10. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

    NARCIS (Netherlands)

    Snijder, Marieke B.; Agyemang, Charles; Peters, Ron J.; Stronks, Karien; Ujcic-Voortman, Joanna K.; van Valkengoed, Irene G. M.

    2017-01-01

    Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We

  11. Effects of a group-based counselling programme on diabetes-related stress, coping, psychological well-being and metabolic control in adults with type 1 or type 2 diabetes.

    Science.gov (United States)

    Karlsen, Bjorg; Idsoe, Thormod; Dirdal, Ingrid; Rokne Hanestad, Berit; Bru, Edvin

    2004-06-01

    This study was designed to determine whether participation in a group-based counselling programme would result in reduced diabetes-related stress, improved coping and psychological well-being as well as achieving glycaemic control closer to an acceptable level. Effects of the programme were evaluated implementing an experimental design with a sample comprising 63 Norwegian adults with both types of diabetes aged between 25 and 70. At the 6-month follow-up, results indicate that the group-based counselling programme tested in the present study has the potential to reduce diabetes-related stress and self-blame as well as to improve coping in adults with diabetes. Moreover, results suggest that the programme can help participants to achieve more acceptable HbA1c levels as well. The present study indicates that this group-based counselling programme is feasible in the sense of suggesting that cognitive restructuring and problem-solving approaches in groups may be useful in helping people adjust to diabetes.

  12. Social participation of diabetes and ex-leprosy patients in the Netherlands and patient preference for combined self-care groups.

    Science.gov (United States)

    de Vries, Henry J C; de Groot, Roos; van Brakel, Wim H

    2014-01-01

    Earlier, we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients, a self-care group exclusively for (ex)leprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease-specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants. Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes toward combined self-care groups for diabetic patients with neuropathy. The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information, and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did acknowledge the comparability with leprosy as far as

  13. Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression.

    Science.gov (United States)

    Odgers-Jewell, K; Ball, L E; Kelly, J T; Isenring, E A; Reidlinger, D P; Thomas, R

    2017-08-01

    Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c ) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy. Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6-10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): -0.48, -0.15; P = 0.0002], 12-14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: -0.49, -0.17; P education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions. Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. © 2017 Diabetes UK.

  14. Effect of polymorphism in insulin locus and HLA on type 1 diabetes in four ethnic groups in Israel.

    Science.gov (United States)

    Benedek, G; Brautbar, C; Vardi, P; Sharon, N; Weintrob, N; Zung, A; Israel, S

    2009-01-01

    This study examined a possible association of the insulin (INS) gene with type 1 diabetes (T1D) in patients and controls from four ethnic groups in Israel. We analyzed the distribution of -23HphI single nucleotide polymorphism (SNP) T/A alleles that correspond to INS variable number of tandem repeat short class I alleles (26-63 repeats) and class III alleles (141-209 repeats), respectively. The -23HphI T/T genotype was found to be positively associated with T1D in three Jewish groups (Yemenites: 93.9% patients vs 68.8% controls, P = 0.0002; Ashkenazi: 80.6% vs 50.8%, P Israel is largely attributed to heterogeneous genetics. Human leukocyte antigen (HLA) results of our previous studies describing the susceptibility and protective haplotypes were used for combined analysis to determine possible interaction between the HLA and INS loci. Only in the Ashkenazi group such interaction was presented with statistical significance.

  15. Impact of Bridging Income Generation with Group Integrated Care (BIGPIC) on Hypertension and Diabetes in Rural Western Kenya.

    Science.gov (United States)

    Pastakia, Sonak D; Manyara, Simon M; Vedanthan, Rajesh; Kamano, Jemima H; Menya, Diana; Andama, Benjamin; Chesoli, Cleophas; Laktabai, Jeremiah

    2017-05-01

    Rural settings in Sub-Saharan Africa (SSA) consistently report low participation in non-communicable disease (NCD) treatment programs and poor outcomes. The objective of this study is to assess the impact of the implementation of a patient-centered rural NCD care delivery model called Bridging Income Generation through grouP Integrated Care (BIGPIC). The study prospectively tracked participation and health outcomes for participants in a screening event and compared linkage frequencies to a historical comparison group. Rural Kenyan participants attending a voluntary NCD screening event were included within the BIGPIC model of care. The BIGPIC model utilizes a contextualized care delivery model designed to address the unique barriers faced in rural settings. This model emphasizes the following steps: (1) find patients in the community, (2) link to peer/microfinance groups, (3) integrate education, (4) treat in the community, (5) enhance economic sustainability and (6) generate demand for care through incentives. The primary outcome is the linkage frequency, which measures the percentage of patients who return for care after screening positive for either hypertension and/or diabetes. Secondary measures include retention frequencies defined as the percentage of patients remaining engaged in care throughout the 9-month follow-up period and changes in systolic (SBP) and diastolic blood pressure (DBP) and blood sugar over 12 months. Of the 879 individuals who were screened, 14.2 % were confirmed to have hypertension, while only 1.4 % were confirmed to have diabetes. The implementation of a comprehensive microfinance-linked, community-based, group care model resulted in 72.4 % of screen-positive participants returning for subsequent care, of which 70.3 % remained in care through the 12 months of the evaluation period. Patients remaining in care demonstrated a statistically significant mean decline of 21 mmHg in SBP [95 % CI (13.9 to 28.4), P < 0.01] and 5

  16. The effect of intensive glucose lowering therapy among major racial/ethnic groups in the Veterans Affairs Diabetes Trial.

    Science.gov (United States)

    Saremi, Aramesh; Schwenke, Dawn C; Bahn, Gideon; Ge, Ling; Emanuele, Nicholas; Reaven, Peter D

    2015-02-01

    To examine the effect of intensive glycemic control on cardiovascular disease events (CVD) among the major race/ethnic groups in a post-hoc analysis of the VADT. Participants included 1111 non-Hispanic Whites, 307 Hispanics and 306 non-Hispanic Blacks randomized to intensive or standard glucose treatment in VADT. Multivariable Cox proportional hazards models were constructed to assess the effect of intensive glucose treatment on CVD events among race/ethnic groups. Mean age was 60.4 years and median follow-up was 5.6 years. By design, modifiable risk factors were managed equally well in both treatment arms and only differed modestly between race/ethnic groups. HbA(1c) decreased significantly from baseline with intensive glucose treatment in each race/ethnic group, with a trend for a greater response in Hispanics (P=0.02 for overall comparison between groups). Intensive glucose treatment was associated with reduced risk of CVD events for Hispanics but not for others (hazard ratios ranged from 0.54 to 0.75 for Hispanics whereas they were consistently close to 1 for others). Sensitivity analyses with different definitions of race/ethnicity or limited to individuals free of previous known CVD yielded similar results. The results of these analyses support the hypothesis that race/ethnicity is worthy of consideration when tailoring intensive treatment for individuals with long-standing type 2 diabetes. However, additional studies are needed to confirm the findings of this post-hoc analysis. Published by Elsevier Inc.

  17. Cardiovascular Disease and Type 2 Diabetes Risk Across Occupational Groups and Industry in a State Wide Study of an Australian Working Population.

    Science.gov (United States)

    Kelsall, Helen Louise; Fernando, Palamandadige Harsha Suranga; Gwini, Stella May; Sim, Malcolm Ross

    2017-11-13

    To investigate prevalence of type 2 diabetes (diabetes) and cardiovascular disease (CVD) risk in occupational and industry groups in a large, diverse working population. 500,000 Victorian workers undertook health checks including lifestyle, anthropometric and biomedical cardiovascular risk factor assessment. 5-year diabetes (AUSDRISK) and absolute CVD risk were estimated. High diabetes and CVD risk was increased in many occupational groups and industries relative to managers and Professional/Scientific/Technical Services respectively. Significantly more blue collar workers had high diabetes risk (males prevalence ratio PR 1.19 (95% CI 1.17-1.20); females 1.34 (1.30-1.38)), high CVD risk (males 1.45 (1.37-1.53); females 1.48 (1.17-1.88), and risk factors including smoking (males 2.26 (2.22-2.30); females 2.20 (2.13-2.27), compared with white collar workers. Targeting occupational and industry groups within sustainable workplace programs could assist in reducing chronic diseases, lowering sickness absence and improving productivity.

  18. Experience of knowledge and skills that are essential in self-managing a chronic condition - a focus group study among people with type 2 diabetes.

    Science.gov (United States)

    Herre, Ann Jorunn; Graue, Marit; Kolltveit, Beate-Christin Hope; Gjengedal, Eva

    2016-06-01

    The purpose of the study was to gain new knowledge about how people experience participating in diabetes self-management courses with other people with type 2 diabetes and how they perceive this influences their health and ability to self-manage the disease. We conducted five focus groups with 22 people with type 2 diabetes who had participated in a group-based diabetes self-management course. We systematically coded the data and analysed them using Knodel's method. Participants gained more nuanced and specific knowledge by participating in a group setting. They increased their theoretical and practical understanding of how to handle diabetes in everyday life. The diabetes self-management course made the participants more aware of having a disease they had to take more seriously. Learning by being in the situation while guided by professionals was useful. In addition, the participation learned from each other by carrying out real tasks in a context with others struggling with similar treatment demands. They wished more room to perform practical tasks and more independent activity. Further, they suggested to make parts of the course accessible online. Still, it was noted that web-based solutions cannot replace the practical parts or the dialogue between the participants. They expressed both a need and a wish for a refresher course. This study underscored that the participants learned through concrete experience, and by trying out practical tasks by becoming part of the diabetes community. They felt safer regarding their own treatment by experiencing a variety of situations in real-life scenarios. © 2015 Nordic College of Caring Science.

  19. Health-related quality of life and self-related health in patients with type 2 diabetes: Effects of group-based rehabilitation versus individual counselling

    Directory of Open Access Journals (Sweden)

    Vadstrup Eva S

    2011-12-01

    Full Text Available Abstract Background Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL and self-rated health in type 2 diabetes patients. Methods We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36 and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R. Results In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12 within the rehabilitation group and 5.6 points (p = 0.03 points among individual counselling participants. In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04. No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01 and 0.34 points within the individual counselling group (p p = 0.01. Conclusions A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling

  20. Diabetes education through group classes leads to better care and outcomes than individual counselling in adults: a population-based cohort study.

    Science.gov (United States)

    Hwee, Jeremiah; Cauch-Dudek, Karen; Victor, J Charles; Ng, Ryan; Shah, Baiju R

    2014-05-09

    Self-management education, supported by multidisciplinary health care teams, is essential for optimal diabetes management. We sought to determine whether acute diabetes complications or quality of care differed for patients in routine clinical care when their self-management education was delivered through group diabetes education classes versus individual counselling. With the use of population-level administrative and primary data, all diabetic patients in Ontario who attended a self-management education program in 2006 were identified and grouped according to whether they attended group classes (n=12,234), individual counselling (n=55,761) or a mixture of both (n=9,829). Acute complications and quality of care in the following year were compared among groups. Compared with those attending individual counselling, patients who attended group classes were less likely to have emergency department visits for hypo/hyperglycemia (odds ratio 0.54, 95% confidence interval [CI]: 0.42-0.68), hypo/hyperglycemia hospitalizations (OR 0.49, CI: 0.32-0.75) or foot ulcers/cellulitis (OR 0.64, CI: 0.50-0.81). They were more likely to have adequate HbA1c testing (OR 1.10, CI: 1.05-1.15) and lipid testing (OR 1.25, CI: 1.19-1.32), and were more likely to receive statins (OR 1.22, CI: 1.07-1.39). Group self-management education was associated with fewer acute complications and some improvements in processes of care. Group sessions can offer care to more patients with reduced human resource requirements. With increased pressure to find efficiencies in health care delivery, group diabetes education may provide an opportunity to deliver less resource-intensive care that simultaneously improves patient care.

  1. Problemática laboral en un grupo de personas con diabetes mellitus Working problems related to a group of persons with diabetes mellitus

    National Research Council Canada - National Science Library

    Rosario García González; Marlene García Castro; Rolando Suárez Pérez; Emma Domínguez Alonso

    2009-01-01

    INTRODUCCIÓN: la diabetes mellitus interfiere en la actividad laboral de las personas y viceversa, sin embargo, son pocos los estudios basados en investigaciones sobre el tema, por lo que pretendemos acercarnos al...

  2. Early management of type 2 diabetes based on a SMBG strategy: the way to diabetes regression--the St Carlos study : a 3-year, prospective, randomized, clinic-based, interventional study with parallel groups.

    Science.gov (United States)

    García de la Torre, Nuria; Durán, Alejandra; Del Valle, Laura; Fuentes, Manuel; Barca, Idoya; Martín, Patricia; Montañez, Carmen; Perez-Ferre, Natalia; Abad, Rosario; Sanz, Fuencisla; Galindo, Mercedes; Rubio, Miguel A; Calle-Pascual, Alfonso L

    2013-08-01

    The aims are to define the regression rate in newly diagnosed type 2 diabetes after lifestyle intervention and pharmacological therapy based on a SMBG (self-monitoring of blood glucose) strategy in routine practice as compared to standard HbA1c-based treatment and to assess whether a supervised exercise program has additional effects. St Carlos study is a 3-year, prospective, randomized, clinic-based, interventional study with three parallel groups. Hundred and ninety-five patients were randomized to the SMBG intervention group [I group; n = 130; Ia: SMBG (n = 65) and Ib: SMBG + supervised exercise (n = 65)] and to the HbA1c control group (C group) (n = 65). The primary outcome was to estimate the regression rate of type 2 diabetes (HbA1c 4 kg was 3.6 (1.8-7); p < 0.001. This study shows that the use of SMBG in an educational program effectively increases the regression rate in newly diagnosed type 2 diabetic patients after 3 years of follow-up. These data suggest that SMBG-based programs should be extended to primary care settings where diabetic patients are usually attended.

  3. The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group.

    Science.gov (United States)

    Walsh, N; George, S; Priest, L; Deakin, T; Vanterpool, G; Karet, B; Simmons, D

    2011-12-01

    Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  4. Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians - the association with adiposity is strongest for ethnic minority women

    Directory of Open Access Journals (Sweden)

    Jenum Anne

    2012-03-01

    Full Text Available Abstract Background The difference in diabetes susceptibility by ethnic background is poorly understood. The aim of this study was to assess the association between adiposity and diabetes in four ethnic minority groups compared with Norwegians, and take into account confounding by socioeconomic position. Methods Data from questionnaires, physical examinations and serum samples were analysed for 30-to 60-year-olds from population-based cross-sectional surveys of Norwegians and four immigrant groups, comprising 4110 subjects born in Norway (n = 1871, Turkey (n = 387, Vietnam (n = 553, Sri Lanka (n = 879 and Pakistan (n = 420. Known and screening-detected diabetes cases were identified. The adiposity measures BMI, waist circumference and waist-hip ratio (WHR were categorized into levels of adiposity. Gender-specific logistic regression models were applied to estimate the risk of diabetes for the ethnic minority groups adjusted for adiposity and income-generating work, years of education and body height used as a proxy for childhood socioeconomic position. Results The age standardized diabetes prevalence differed significantly between the ethnic groups (women/men: Pakistan: 26.4% (95% CI 20.1-32.7/20.0% (14.9-25.2; Sri Lanka: 22.5% (18.1-26.9/20.7% (17.3-24.2, Turkey: 11.9% (7.2-16.7/12.0% (7.6-16.4, Vietnam: 8.1% (5.1-11.2/10.4% (6.6-14.1 and Norway: 2.7% (1.8-3.7/6.4% (4.6-8.1. The prevalence increased more in the minority groups than in Norwegians with increasing levels of BMI, WHR and waist circumference, and most for women. Highly significant ethnic differences in the age-standardized prevalence of diabetes were found for both genders in all categories of all adiposity measures (p Conclusions A high prevalence of diabetes was found in 30-to 60-year-olds from ethnic minority groups in Oslo, with those from Sri Lanka and Pakistan at highest risk. For all levels of adiposity, a higher susceptibility for diabetes was observed for ethnic minority

  5. Long-term prognosis of diabetic patients with myocardial infarction: relation to antidiabetic treatment regimen. The TRACE Study Group

    DEFF Research Database (Denmark)

    Gustafsson, I; Hildebrandt, P; Seibaek, M

    2000-01-01

    AIMS: The present study was performed to evaluate pre-admission history, presentation, initial treatment and long-term mortality in patients with myocardial infarction and diabetes. METHODS AND RESULTS: Between 1990 and 1992, 6676 patients with acute myocardial infarction were screened for entry...... into the Trandolapril Cardiac Evaluation (TRACE) study. In this cohort 719 (11%) of the patients had a history of diabetes. Among the diabetic patients 19% were treated with insulin, 52% with oral hypoglycaemic agents and 29% with diet only. The diabetic patients were slightly older, more likely to be female and had...... a higher prevalence of known cardiovascular disease. Even though the diabetic patients had the same frequency of ST-segment elevation on the electrocardiogram and the same admission delay, treatment with thrombolysis and aspirin was less frequently prescribed to the diabetic patients than to patients...

  6. Association between maternal serum high mobility group box 1 levels and pregnancy complicated by gestational diabetes mellitus.

    Science.gov (United States)

    Giacobbe, A; Granese, R; Grasso, R; Salpietro, V; Corrado, F; Giorgianni, G; Foti, G; Amadore, D; Triolo, O; Giunta, L; Di Benedetto, A

    2016-05-01

    Gestational diabetes mellitus (GDM), is characterized by chronic, low-grade subclinical inflammation with altered production of cytokines and mediators. Recently, a new protein acting as a "danger signal", high mobility group box 1 (HMGB1), that migrates quickly during electrophoresis, has been identified. The aim of our study was to analyze serum levels of HMGB1 in pregnant women, with or without GDM, in the third trimester of pregnancy to evaluate correlation with insulin resistance and other risk factors for GDM. Seventy five pregnant women positive to the 75 g oral glucose tolerance test (OGTT) were included in the study group and 48 pregnant women who were negative to the screening test, were randomly selected using a computer-generated randomisation table. A significant positive univariate correlation was observed between serum HMGB1 levels, HOMA-IR index, glycaemia values at OGTT and pre-pregnancy BMI. Moreover, logistic regression analysis showed that serum HMGB1 was independent linked to GDM. Our study demonstrated that HMGB1, a marker of chronic inflammation, is associated to GDM and insulin resistance level, in the third trimester of pregnancy. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  7. Consistent association of type 2 diabetes risk variants found in europeans in diverse racial and ethnic groups.

    Directory of Open Access Journals (Sweden)

    Kevin M Waters

    2010-08-01

    Full Text Available It has been recently hypothesized that many of the signals detected in genome-wide association studies (GWAS to T2D and other diseases, despite being observed to common variants, might in fact result from causal mutations that are rare. One prediction of this hypothesis is that the allelic associations should be population-specific, as the causal mutations arose after the migrations that established different populations around the world. We selected 19 common variants found to be reproducibly associated to T2D risk in European populations and studied them in a large multiethnic case-control study (6,142 cases and 7,403 controls among men and women from 5 racial/ethnic groups (European Americans, African Americans, Latinos, Japanese Americans, and Native Hawaiians. In analysis pooled across ethnic groups, the allelic associations were in the same direction as the original report for all 19 variants, and 14 of the 19 were significantly associated with risk. In summing the number of risk alleles for each individual, the per-allele associations were highly statistically significant (P<10(-4 and similar in all populations (odds ratios 1.09-1.12 except in Japanese Americans the estimated effect per allele was larger than in the other populations (1.20; P(het = 3.8×10(-4. We did not observe ethnic differences in the distribution of risk that would explain the increased prevalence of type 2 diabetes in these groups as compared to European Americans. The consistency of allelic associations in diverse racial/ethnic groups is not predicted under the hypothesis of Goldstein regarding "synthetic associations" of rare mutations in T2D.

  8. Evaluation of a programme of group visits and computer-assisted consultations in the treatment of adolescents with Type 1 diabetes.

    Science.gov (United States)

    Graue, M; Wentzel-Larsen, T; Hanestad, B R; Søvik, O

    2005-11-01

    To examine the effects of group visits and computer-assisted consultations on quality of life and glycaemic control in adolescents with Type 1 diabetes. A total of 116 adolescents, aged 11-17 years, and their parents were randomly assigned to an intervention (n = 62) or a control group (n = 54). The intervention group was invited to a 15-month programme comprising group visits and computer-assisted consultations. The control group was offered traditional out-patient consultations. Outcomes included changes in HbA(1c) and the adolescents' assessment of generic and disease-specific health-related quality of life measured by the Child Health Questionnaire (CHQ-CF87) and the Diabetes Quality of Life Questionnaire (DQOL), respectively. One hundred and one adolescents (55/46) agreed to participate, mean age 14.2 years (sd 1.5), mean diabetes duration 6.5 years (sd 3.6, range 1-16 years), mean HbA(1c) 9.3% (sd 1.4, range 6.1-12.8%). Eighty-three (72%) completed the questionnaires at follow-up (intervention/control 45/38). There were significant age by randomization group interactions for diabetes-related impact (P = 0.018), diabetes-related worries (P = 0.004), mental health (P = 0.046) and general behaviour (P = 0.029), implying that the intervention was effective in older adolescents (above 13-14 years). No significant effects on mean HbA(1c) were identified. Group visits and computer-assisted consultations had beneficial effects on health-related quality of life in older adolescents, the role of this intervention being questionable in younger adolescents.

  9. Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie's disease? Analysis in 279 patients with a control group in Sicily

    National Research Council Canada - National Science Library

    Pavone, Carlo; D'Amato, Francesco; Dispensa, Nino; Torretta, Federico; Magno, Carlo

    2015-01-01

    ...), the second one composed by patients with other andrological diseases (control arm). For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function...

  10. The Effect of Group Discussion-based Education on Self-management of Adults with Type 2 Diabetes Mellitus Compared with Usual Care: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Hosein Habibzadeh

    2017-11-01

    Full Text Available Objectives: We sought to determine the effect of group discussion-based education on the self-management capability of patients with type 2 diabetes in Iran. Methods: This randomized control trial was conducted on 90 patients with type 2 diabetes. Participants were allocated randomly into one of two groups; intervention and control. The intervention group received the group discussion-based education while the control group received routine care only. The Lin’s self-management questionnaire was completed at baseline and three months post-intervention. Results: Statistical analysis, including the use of independent t-test, identified that in comparison to the control group, significant increases were observed in the scores of self-organization (t =11.24, p < 0.001, self-adjustment (t = 7.53, p < 0.001, interaction with health experts (t = 7.31, p < 0.001, blood sugar self-monitoring (t = 6.42, p < 0.001, adherence to the proposed diet (t = 5.22, p < 0.001, and total self-management (t = 10.82, p < 0.001 in the intervention group. Conclusions: Sharing experiences through group discussions and receiving instructive feedback can improve the ability to self-manage diabetes.

  11. [An analysis of the educational effects of group counseling with visual aids: efforts to prevent diabetes in a business office setting].

    Science.gov (United States)

    Satou, Yuka; Kanda, Junko; Okumura, Mayumi; Nishida, Kazuko

    2004-07-01

    We made this report with a view to clarifying the effects of group counseling with visual aids for railway workers enjoying improved health conducted as a part of prevention activities for lifestyle-related diseases such as diabetes. We employed the use of visual aids including slides, samples of blood and the measurement of vascular age on diabetes, and carried out group counseling to improve the interest, knowledge and realization of diabetes and lifestyle. This group counseling was carried out both with and without visual aids. A comparative study of the immediate effects mediated by the use or absence of visual aids was conducted. The workers who accepted our study and cooperated with us totaled 1054 (the average age was 43 +/- 11.2). We divided them at random into the object group and comparative control group and two months later we were able to analyze 190 people among them who could be traced and followed up. As a result of using visual aids, the workers showed much more interest and realization of diabetes and their lifestyles (p visual aids in retention of this knowledge. On the other hand, we have not yet seen improvement in the physical data through group counseling. It is possible that the medical examination data taken beforehand for the object group and the comparative control group were both within the normal range, or the follow-up period was short at only two months after the group counseling was conducted. We conclude that the use of visual aids could lead to a change in consciousness among workers having some confidence in their health as the result of group counseling.

  12. Impact of a nutrition/educational program in a group of type 2 diabetes patients, already involved in a wider "Group Care" plan and not achieving complete target: an observational study.

    Science.gov (United States)

    Comba, Anna; Ardizzone, Alessandra; Leto, Laura; Feola, Mauro

    2017-05-18

    Type 2 diabetes is one of the most frequent chronic degenerative diseases in the world (5.4% in Italy); it has many chronic consequences with a significant impact either on expectation or quality of life. About 80-90% of type 2 diabetes patients is either overweight or obese, condition that can cause many more negative consequences than in individuals in the same conditions but with normal weight. The aim of the research is to assess if diabetic people who cannot reach the goals of glycemic control, good eating habits and weight loss can eventually obtain, with an individualized care plan, long lasting improvements. This study involved a little group of diabetic patients who did not achieve an optimal therapeutic target. These patients have been individually followed by a dietician for six months through a program of dietetic counseling and regular controls and at the end we compare the results of another group of diabetic people, involved in the Group Care Plan (but without the support of the dietitian). The nutrition educational program determined a significant weight loss (- 4.62 kg vs + 3.46 kg; p<0.05), a reduction of waist circumference (-5.34 cm vs + 4.15 cm; p<0.05), an improvement of glycemic control (Hb1Ac: - 0.67 % vs + 0.57%; p<0.05), lipidic profile (total cholesterol: - 1 mg/dl vs + 12.85 mg/dl; p<0.05) and perceived quality of life (Test Att 19: 0 subjects vs 6 subjects). An individualized nutrition educational program in patients with type 2 diabetes not achieving a therapeutic target can optimize global care of the disease.

  13. [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

  14. A structured, group-based diabetes self-management education (DSME) programme for people, families and whanau with type 2 diabetes (T2DM) in New Zealand: an observational study.

    Science.gov (United States)

    Krebs, J D; Parry-Strong, A; Gamble, E; McBain, L; Bingham, L J; Dutton, E S; Tapu-Ta'ala, S; Howells, J; Metekingi, H; Smith, R B W; Coppell, K J

    2013-07-01

    Group-based diabetes self-management education (DSME) programmes have been shown to be effective. A programme tailored for the unique social and ethnic environment of New Zealand (NZ) was developed using concepts from internationally developed programmes. To assess the effectiveness of a 6 week New Zealand specific DSME programme. In this observational study people with type 2 diabetes (aged 18-80 years) from diverse cultural backgrounds were recruited from primary care. Seventeen groups of six education sessions were run. Clinical data were collected from primary care at baseline, 3, 6 and 9 months. Participants also completed a self-administered questionnaire on diabetes knowledge, and self-management behaviours. 107 participants, mean age 56.7±11.3 years and mean duration of diabetes 7.5±7 years (NZ European (44%), Maori (24%), Pacific (16%) and Indian (16%)), were enrolled. Confidence in self-managing diabetes, regular examination of feet, physical activity levels and smoking rates all improved. Glycaemic control improved between baseline and 6 months (HbA1C 64.9±20.0 mmol/mol to 59.9±13.9 mmol/mol (p<0.05) (baseline 8.07%±1.80, 6 months 7.62%±1.25)), but was no different to baseline at 9 months. Systolic BP reduced from 131.9±16.4 to 127.4±18.2 mmHg (p<0.05) at 6 months, but increased to baseline levels by 9 months. Diastolic BP, triglycerides and urine microalbumin:creatinine ratio were significantly reduced at 3, 6 and 9 months. A group-based DSME programme designed specifically for the NZ population was effective at improving aspects of diabetes care at 6 months. The attenuation of these improvements after 6 months suggests a refresher course at that time may be beneficial. Copyright © 2013. Published by Elsevier Ltd.

  15. Impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches.

    Science.gov (United States)

    Simmons, David; Prevost, A Toby; Bunn, Chris; Holman, Daniel; Parker, Richard A; Cohn, Simon; Donald, Sarah; Paddison, Charlotte A M; Ward, Candice; Robins, Peter; Graffy, Jonathan

    2015-01-01

    Diabetes peer support, where one person with diabetes helps guide and support others, has been proposed as a way to improve diabetes management. We have tested whether different diabetes peer support strategies can improve metabolic and/or psychological outcomes. People with type 2 diabetes (n = 1,299) were invited to participate as either 'peer' or 'peer support facilitator' (PSF) in a 2x2 factorial randomised cluster controlled trial across rural communities (130 clusters) in England. Peer support was delivered over 8-12 months by trained PSFs, supported by monthly meetings with a diabetes educator. Primary end point was HbA1c. Secondary outcomes included quality of life, diabetes distress, blood pressure, waist, total cholesterol and weight. Outcome assessors and investigators were masked to arm allocation. Main factors were 1:1 or group intervention. Analysis was by intention-to-treat adjusting for baseline. The 4 arms were well matched (Group n = 330, 1:1(individual) n = 325, combined n = 322, control n = 322); 1035 (79·7%) completed the mid-point postal questionnaire and 1064 (81·9%) had a final HbA1c. A limitation was that although 92.6% PSFs and peers were in telephone contact, only 61.4% of intervention participants attended a face to face session. Mean baseline HbA1c was 57 mmol/mol (7·4%), with no significant change across arms. Follow up systolic blood pressure was 2·3 mm Hg (0.6 to 4.0) lower among those allocated group peer-support and 3·0 mm Hg (1.1 to 5.0) lower if the group support was attended at least once. There was no impact on other outcomes by intention to treat or significant differences between arms in self-reported adherence or medication. Group diabetes peer support over 8-12 months was associated with a small improvement in blood pressure but no other significant outcomes. Long term benefits should be investigated. ISRCTN.com ISRCTN6696362166963621.

  16. Nutrition management for individuals with noninsulin-dependent diabetes mellitus in the 1990s: a review by the Diabetes Care and Education dietetic practice group.

    Science.gov (United States)

    Beebe, C A; Pastors, J G; Powers, M A; Wylie-Rosett, J

    1991-02-01

    Noninsulin-dependent diabetes mellitus (NIDDM), or Type II diabetes, is characterized by two primary defects: insulin resistance and insulin secretion. The two major goals of management of NIDDM are to achieve near normal metabolic control and to prevent/delay the microvascular and macrovascular complications of diabetes. Nutrition, exercise, and, if necessary, medication are the three primary treatment modalities used in NIDDM. Treatment regimens need to be individualized and developed with consideration for diabetes management goals and quality-of-life issues. Lean individuals with NIDDM should be encouraged to maintain their body weight and modify food composition and eating pattern to minimize glucose excursions. The primary treatment goal for an obese individual with NIDDM is weight loss. The process of teaching nutrition and meal planning involves developing a cooperative alliance, gathering information, setting realistic goals, intervention, and maintaining change. Nutrition intervention involves providing information in stages, beginning with "survival skill" information and progressing to in-depth information. The dietitian's responsibility is to promote continuity of learning by introducing new ideas and concepts and altering the learning environment. Dietitians can expand their role in the 1990s to that of a diabetes educator taking a leadership role to ensure that the individual with NIDDM receives comprehensive and individualized care.

  17. Utilization of International Association of Diabetes and Pregnancy Study Groups criteria vs. a two-step approach to screening for gestational diabetes mellitus in Chinese women with twin pregnancies.

    Science.gov (United States)

    Liu, X; Chen, Y; Zhou, Q; Shi, H; Cheng, W W

    2015-03-01

    To evaluate prevalence and pregnancy outcomes using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and screening protocol vs. a standard two-step screening approach for gestational diabetes mellitus in Chinese twin pregnancies. A retrospective cohort study for pregnancies during 2007-2013 was performed in a tertiary hospital in Shanghai, China. Data were abstracted from the medical records of twin pregnancies delivered at the hospital. During the period 2007-2011, this hospital used a two-step approach with a 50 g screening with a cut-off value of ≥ 7.8 mmol/l followed by a 100 g diagnostic oral glucose tolerance test (OGTT) utilizing Carpenter-Coustan criteria. In 2012-2013, the hospital switched to the IADPSG protocol of universal 75 g OGTT. Among 1461 twin pregnancies, 643 were screened utilizing IADPSG criteria and 818 using the two-step protocol. Gestational diabetes mellitus was diagnosed more frequently in the IADPSG group than in the two-step group [20.4% and 7.0%, respectively; adjusted odds ratio (aOR) = 3.22; 95% confidence interval (CI) = 2.30-4.52]. During the IADPSG period, the incidence of pre-eclampsia was 38% lower in non-gestational diabetes mellitus affected pregnancies compared with the two-step period (aOR = 0.62; 95% CI = 0.44-0.87). We observed no significant differences in most perinatal outcomes between the two groups. Compared with a standard two-step approach to screening and diagnosis, the IADPSG screening method resulted in a three-fold increase in the incidence of gestational diabetes mellitus in twin pregnancies, with a 38% lower risk of pre-eclampsia but no significant difference in most perinatal outcomes in non-gestational diabetes mellitus affected pregnancies. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  18. Knowledge, attitudes, practices, and barriers reported by patients receiving diabetes and hypertension primary health care in Barbados: a focus group study.

    Science.gov (United States)

    Adams, O Peter; Carter, Anne O

    2011-12-02

    Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. This study aimed to explore the knowledge, attitudes and practices, and the barriers faced by people with diabetes and hypertension in Barbados that might contribute to these deficiencies. Five structured focus groups were conducted for randomly selected people with diabetes and hypertension. Twenty-one patients (5 diabetic, 5 hypertensive, and 11 with both diseases) with a mean age of 59 years attended 5 focus group sessions.Patient factors that affected care included the difficulty in maintaining behaviour change. Practitioner factors included not considering the "whole person" and patient expectations, and not showing enough respect for patients. Health care system factors revolved around the amount of time spent accessing care because of long waiting times in public sector clinics and pharmacies. Society related barriers included the high cost and limited availability of appropriate food, the availability of exercise facilities, stigma of disease and difficulty taking time off work.Attendees were not familiar with guidelines for diabetes and hypertension management, but welcomed a patient version detailing a place to record results, the frequency of tests, and blood pressure and blood glucose targets. Appropriate education from practitioners during consultations, while waiting in clinic, through support and education groups, and for the general public through the schools, mass media and billboards were recommended. Primary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts.

  19. Knowledge, attitudes, practices, and barriers reported by patients receiving diabetes and hypertension primary health care in Barbados: a focus group study

    Directory of Open Access Journals (Sweden)

    Adams O Peter

    2011-12-01

    Full Text Available Abstract Background Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. This study aimed to explore the knowledge, attitudes and practices, and the barriers faced by people with diabetes and hypertension in Barbados that might contribute to these deficiencies. Methods Five structured focus groups were conducted for randomly selected people with diabetes and hypertension. Results Twenty-one patients (5 diabetic, 5 hypertensive, and 11 with both diseases with a mean age of 59 years attended 5 focus group sessions. Patient factors that affected care included the difficulty in maintaining behaviour change. Practitioner factors included not considering the "whole person" and patient expectations, and not showing enough respect for patients. Health care system factors revolved around the amount of time spent accessing care because of long waiting times in public sector clinics and pharmacies. Society related barriers included the high cost and limited availability of appropriate food, the availability of exercise facilities, stigma of disease and difficulty taking time off work. Attendees were not familiar with guidelines for diabetes and hypertension management, but welcomed a patient version detailing a place to record results, the frequency of tests, and blood pressure and blood glucose targets. Appropriate education from practitioners during consultations, while waiting in clinic, through support and education groups, and for the general public through the schools, mass media and billboards were recommended. Conclusions Primary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts.

  20. Development of an acceptable and feasible self-management group for children, young people and families living with Type 1 diabetes.

    Science.gov (United States)

    Cai, R A; Holt, R I G; Casdagli, L; Viner, R M; Thompson, R; Barnard, K; Christie, D

    2017-06-01

    This study developed an acceptable and feasible self-management intervention that addresses the self-identified needs of children and young people with Type 1 diabetes and their parents. Phase 1 reviewed previous interventions and interviewed the clinical team, young people and families. Phase 2 ran three age-matched focus groups with 11 families of children aged 8-16 years. Feedback was used to modify the workshop. Phase 3 evaluated feasibility of delivery, as well as the effects on metabolic control, quality of life and fear of hypoglycaemia, measured at baseline and 1-3 months post intervention. Eighty-nine families were invited to take part. Twenty-two (25%) participated in seven pilot groups (median age of young people 10 years, 36% girls). The intervention comprised a developmentally appropriate workshop for young people and parents addressing: (1) blood glucose control, (2) the potential impact of long-term high HbA1c , (3) the effects of 'hypos' and 'hypers', (4) self-management techniques and (5) talking confidently to people about diabetes. Participants were enthusiastic and positive about the workshop and would recommend it to others. Young people liked sharing ideas and meeting others with diabetes, while parents enjoyed listening to their children talk about their diabetes knowledge. Families living with Type 1 diabetes participated in developing a self-management group intervention. Although we demonstrated acceptability and feasibility, the pilot study results do not support the development of a randomized control trial to evaluate the effectiveness in improving HbA1c . © 2017 Diabetes UK.

  1. The effects and costs of a group-based education programme for self-management of patients with Type 2 diabetes. A community-based study

    DEFF Research Database (Denmark)

    Mølsted, Stig; Tribler, Jane; Poulsen, Peter B.

    2012-01-01

    The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type...... 2 diabetes. Seven hundred and two patients undergoing treatment by general practitioners (GPs) were included. The education comprised three modules over a 12-month period. It was based on the empowerment philosophy. The education followed a written curriculum, and the educators were given special...... training in its use. Glycemic control (HbA1c) was found to improve from 7.34 ± 1.34 to 6.88 ± 1.09%, P education programme. Moreover, significant improvements were found in terms of fasting blood glucose, blood...

  2. Frecuencia de disfunción sexual en un grupo de pacientes diabéticas mexicanas Frequency of sexual dysfunction in a group of Mexican diabetic patients

    Directory of Open Access Journals (Sweden)

    Claudia Edith Gaspar Ramón

    2013-03-01

    there is a higher frequency of sexual dysfunction in patients who suffer from Type 2 diabetes mellitus as compared with non diabetic patients. Methods: we performed a case study and a control to the "Marina Nacional" Family Medicine Unit in Mexico City. We selected 32 patients suffering from Type 2 diabetes mellitus aged 35 - 50 years who had history of more than two years´ evolution of the disease. The control group was composed of 32 patients of the same age that presented to the same medical unit complaining of other health problems different from chronic diseases. Both groups were applied the same standardized self-assessment questionnaire Arizona Sexual Experience Scale (ASEX. Later, the degree of metabolic control and the time of evolution of the disease with sexual dysfunction were correlated. Results: it was identified that the presence of sexual dysfunction in patients suffering from diabetes mellitus was higher than in non diabetic patients. We found no evidence of the association between sexual dysfunction and the time of evolution of diabetes or between sexual dysfunction and metabolic control. Conclusions: female sexual dysfunction was more frequent in diabetic women.

  3. HMGCS2 is a key ketogenic enzyme potentially involved in type 1 diabetes with high cardiovascular risk.

    Science.gov (United States)

    Shukla, Sanket Kumar; Liu, Weijing; Sikder, Kunal; Addya, Sankar; Sarkar, Amrita; Wei, Yidong; Rafiq, Khadija

    2017-07-04

    Diabetes increases the risk of Cardio-vascular disease (CVD). CVD is more prevalent in type 2 diabetes (T2D) than type 1 diabetes (T1D), but the mortality risk is higher in T1D than in T2D. The pathophysiology of CVD in T1D is poorly defined. To learn more about biological pathways that are potentially involved in T1D with cardiac dysfunction, we sought to identify differentially expressed genes in the T1D heart. Our study used T1D mice with severe hyperglycemia along with significant deficits in echocardiographic measurements. Microarray analysis of heart tissue RNA revealed that the T1D mice differentially expressed 10 genes compared to control. Using Ingenuity Pathway Analysis (IPA), we showed that these genes were significantly involved in ketogenesis, cardiovascular disease, apoptosis and other toxicology functions. Of these 10 genes, the 3-Hydroxy-3-Methylglutaryl-CoA Synthase 2 (HMGCS2) was the highest upregulated gene in T1D heart. IPA analysis showed that HMGCS2 was center to many biological networks and pathways. Our data also suggested that apart from heart, the expression of HMGCS2 was also different in kidney and spleen between control and STZ treated mice. In conclusion, The HMGCS2 molecule may potentially be involved in T1D induced cardiac dysfunction.

  4. A nation-wide cross-sectional study of urinary albumin excretion rate, arterial blood pressure and blood glucose control in Danish children with type 1 diabetes mellitus. Danish Study Group of Diabetes in Childhood

    DEFF Research Database (Denmark)

    Mortensen, H B; Marinelli, K; Nørgaard, K

    1990-01-01

    . Among the patients with Type 1 diabetes, 4.3% (18 males and 23 females) had AER greater than 20 to 150 micrograms min-1 (persistent microalbuminuria). A further 7 adolescents (0.7%) had overt proteinuria (greater than 150 micrograms min-1). Clinical data for the 41 diabetic patients with AER greater...... than 20 to 150 micrograms min-1 were compared with those for 569 diabetic adolescents with AER less than or equal to 20 micrograms min-1 and duration of diabetes more than 2 years. The group with AER greater than 20 to 150 micrograms min-1 had significantly higher mean age (16.5 years) than the group...... with AER less than or equal to 20 micrograms min-1 (15.0 years; p less than 0.001). Females with AER greater than 20 to 150 micrograms min-1 had significantly higher mean HbA1c level (10.8 +/- 1.9%) than those with AER less than or equal to 20 micrograms min-1 (9.8 +/- 1.9%, p less than 0.003); they also...

  5. Association of the consumption of common food groups and beverages with mortality from cancer, ischaemic heart disease and diabetes mellitus in Serbia, 1991-2010: an ecological study.

    Science.gov (United States)

    Ilic, Milena; Ilic, Irena; Stojanovic, Goran; Zivanovic-Macuzic, Ivana

    2016-01-05

    This paper reports association between mortality rates from cancer, ischaemic heart disease and diabetes mellitus and the consumption of common food groups and beverages in Serbia. In this ecological study, data on both mortality and the average annual consumption of common food groups and beverages per household's member were obtained from official data-collection sources. The multivariate linear regression analysis was used to determine the strength of the associations between consumption of common food groups and beverages and mortality rates. Markedly increasing trends of cancer, ischaemic heart disease and diabetes mellitus mortality rates were observed in Serbia in the period 1991-2010. Mortality rates from cancer were negatively associated with consumption of vegetable oil (p=0.005) and grains (p=0.001), and same was found for ischaemic heart disease (p=0.002 and 0.021, respectively), while consumption of other dairy products showed a significant positive association (ptrends from cancer, ischaemic heart disease and diabetes mellitus, and common food groups and beverages consumption was observed and should be assessed in future analytical epidemiological studies. Promotion of healthy diet is sorely needed in Serbia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression.

    Science.gov (United States)

    Ricci-Cabello, Ignacio; Ruiz-Pérez, Isabel; Rojas-García, Antonio; Pastor, Guadalupe; Rodríguez-Barranco, Miguel; Gonçalves, Daniela C

    2014-07-19

    It is not clear to what extent educational programs aimed at promoting diabetes self-management in ethnic minority groups are effective. The aim of this work was to systematically review the effectiveness of educational programs to promote the self-management of racial/ethnic minority groups with type 2 diabetes, and to identify programs' characteristics associated with greater success. We undertook a systematic literature review. Specific searches were designed and implemented for Medline, EMBASE, CINAHL, ISI Web of Knowledge, Scirus, Current Contents and nine additional sources (from inception to October 2012). We included experimental and quasi-experimental studies assessing the impact of educational programs targeted to racial/ethnic minority groups with type 2 diabetes. We only included interventions conducted in countries members of the OECD. Two reviewers independently screened citations. Structured forms were used to extract information on intervention characteristics, effectiveness, and cost-effectiveness. When possible, we conducted random-effects meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. Two reviewers independently extracted all the information and critically appraised the studies. We identified thirty-seven studies reporting on thirty-nine educational programs. Most of them were conducted in the US, with African American or Latino participants. Most programs obtained some benefits over standard care in improving diabetes knowledge, self-management behaviors and clinical outcomes. A meta-analysis of 20 randomized controlled trials (3,094 patients) indicated that the programs produced a reduction in glycated hemoglobin of -0.31% (95% CI -0.48% to -0.14%). Diabetes knowledge and self-management measures were too heterogeneous to pool. Meta-regressions showed larger reduction in glycated hemoglobin in individual and face to face delivered interventions, as well as in those

  7. Elevated Fasting Blood Glucose Is Predictive of Poor Outcome in Non-Diabetic Stroke Patients: A Sub-Group Analysis of SMART.

    Directory of Open Access Journals (Sweden)

    Ming Yao

    Full Text Available Although increasing evidence suggests that hyperglycemia following acute stroke adversely affects clinical outcome, whether the association between glycaemia and functional outcome varies between stroke patients with\\without pre-diagnosed diabetes remains controversial. We aimed to investigate the relationship between the fasting blood glucose (FBG and the 6-month functional outcome in a subgroup of SMART cohort and further to assess whether this association varied based on the status of pre-diagnosed diabetes.Data of 2862 patients with acute ischemic stroke (629 with pre-diagnosed diabetics enrolled from SMART cohort were analyzed. Functional outcome at 6-month post-stroke was measured by modified Rankin Scale (mRS and categorized as favorable (mRS:0-2 or poor (mRS:3-5. Binary logistic regression model, adjusting for age, gender, educational level, history of hypertension and stroke, baseline NIHSS and treatment group, was used in the whole cohort to evaluate the association between admission FBG and functional outcome. Stratified logistic regression analyses were further performed based on the presence/absence of pre-diabetes history.In the whole cohort, multivariable logistical regression showed that poor functional outcome was associated with elevated FBG (OR1.21 (95%CI 1.07-1.37, p = 0.002, older age (OR1.64 (95% CI1.38-1.94, p<0.001, higher NIHSS (OR2.90 (95%CI 2.52-3.33, p<0.001 and hypertension (OR1.42 (95%CI 1.13-1.98, p = 0.04. Stratified logistical regression analysis showed that the association between FBG and functional outcome remained significant only in patients without pre-diagnosed diabetes (OR1.26 (95%CI 1.03-1.55, p = 0.023, but not in those with premorbid diagnosis of diabetes (p = 0.885.The present results demonstrate a significant association between elevated FBG after stroke and poor functional outcome in patients without pre-diagnosed diabetes, but not in diabetics. This finding confirms the importance of glycemic

  8. Diabetes-Induced Oxidative Stress in Endothelial Progenitor Cells May Be Sustained by a Positive Feedback Loop Involving High Mobility Group Box-1

    Directory of Open Access Journals (Sweden)

    Han Wu

    2016-01-01

    Full Text Available Oxidative stress is considered to be a critical factor in diabetes-induced endothelial progenitor cell (EPC dysfunction, although the underlying mechanisms are not fully understood. In this study, we investigated the role of high mobility group box-1 (HMGB-1 in diabetes-induced oxidative stress. HMGB-1 was upregulated in both serum and bone marrow-derived monocytes from diabetic mice compared with control mice. In vitro, advanced glycation end productions (AGEs induced, expression of HMGB-1 in EPCs and in cell culture supernatants in a dose-dependent manner. However, inhibition of oxidative stress with N-acetylcysteine (NAC partially inhibited the induction of HMGB-1 induced by AGEs. Furthermore, p66shc expression in EPCs induced by AGEs was abrogated by incubation with glycyrrhizin (Gly, while increased superoxide dismutase (SOD activity in cell culture supernatants was observed in the Gly treated group. Thus, HMGB-1 may play an important role in diabetes-induced oxidative stress in EPCs via a positive feedback loop involving the AGE/reactive oxygen species/HMGB-1 pathway.

  9. Preliminary Efficacy of Group Medical Nutrition Therapy and Motivational Interviewing among Obese African American Women with Type 2 Diabetes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Stephania T. Miller

    2014-01-01

    Full Text Available Objective. To assess the efficacy and acceptability of a group medical nutritional therapy (MNT intervention, using motivational interviewing (MI. Research Design & Method. African American (AA women with type 2 diabetes (T2D participated in five, certified diabetes educator/dietitian-facilitated intervention sessions targeting carbohydrate, fat, and fruit/vegetable intake and management. Motivation-based activities centered on exploration of dietary ambivalence and the relationships between diet and personal strengths. Repeated pre- and post-intervention, psychosocial, dietary self-care, and clinical outcomes were collected and analyzed using generalized least squares regression. An acceptability assessment was administered after intervention. Results. Participants (n = 24 were mostly of middle age (mean age 50.8 ± 6.3 with an average BMI of 39 ± 6.5. Compared to a gradual pre-intervention loss of HbA1c control and confidence in choosing restaurant foods, a significant post-intervention improvement in HbA1c (P = 0.03 and a near significant (P = 0.06 increase in confidence in choosing restaurant foods were observed with both returning to pre-intervention levels. 100% reported that they would recommend the study to other AA women with type 2 diabetes. Conclusion. The results support the potential efficacy of a group MNT/MI intervention in improving glycemic control and dietary self-care-related confidence in overweight/obese AA women with type 2 diabetes.

  10. Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews.

    Science.gov (United States)

    Atwine, Fortunate; Hultsjö, Sally; Albin, Björn; Hjelm, Katarina

    2015-01-01

    Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers. Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39-72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups. Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends. The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care.

  11. Crestal Bone Loss under Delayed Loading of Full Thickness Versus Flapless Surgically Placed Dental Implants in Controlled Type 2 Diabetic Patients: A Parallel Group Randomized Clinical Trial.

    Science.gov (United States)

    Yadav, Rohit; Agrawal, Kaushal Kishor; Rao, Jitendra; Anwar, Mohd; Alvi, Habib Ahmed; Singh, Kalpana; Himanshu, D

    2016-10-12

    To compare crestal bone loss around dental implants using a delayed loading protocol. Bone loss was compared in patients following conventional full thickness flap and flapless surgery in controlled type 2 diabetic patients. Eighty-eight type 2 diabetic patients satisfying predetermined inclusion and exclusion criteria were selected for this single center, parallel group study after obtaining institutional review board approval and informed consent. These patients were randomly divided into two groups. Group I consisted of patients undergoing full thickness flap surgery for implant placement, and group II consisted of patients undergoing flapless surgery for implant placement. The mean age, duration of diabetes, glycosylated hemoglobin levels, and male-to-female ratio in both groups were matched and compared statistically. Dental implants were placed followed by delayed loading (4 months) in both groups. Crestal bone loss was assessed with intraoral periapical radiographs with the help of computer software (DBSWIN viewer). Actual implant length acted as the radiographic index, and implant-abutment junctions were used as a reference point for all measurements. Mesial and distal bone levels at baseline, 6, and 12 months post implant placement of the two groups were determined. Mesial and distal crestal bone loss from baseline to 6 and 12 months were calculated and compared with Tukey test using SPSS v15.0 statistical analysis software. Tukey test revealed similar (not statistically different) mean mesial crestal bone loss between the two groups after 6 months (0.47 ± 0.08 mm vs. 0.36 ± 0.13 mm, p = 0.576) and after 12 months (1.56 ± 0.25 mm vs. 1.50 ± 0.22 mm, p = 0.891). The mean distal bone loss resulting between the two groups was not statistically different at 6 months (0.44 ± 0.08 mm vs. 0.35 ± 0.12 mm, p = 0.687) and at 12 months (1.57 ± 0.23 mm vs. 1.61 ± 0.22 mm, p = 0.947). The results of this clinical randomized control trial indicated that in

  12. Group-based developmental BMI trajectories, polycystic ovary syndrome, and gestational diabetes: a community-based longitudinal study.

    Science.gov (United States)

    Kakoly, Nadira Sultana; Earnest, Arul; Moran, Lisa J; Teede, Helena J; Joham, Anju E

    2017-11-06

    Obesity is common in young women, increasing insulin resistance (IR) and worsening pregnancy complications, including gestational diabetes (GDM). Women with polycystic ovary syndrome (PCOS) are commonly obese, which aggravates the severity of PCOS clinical expression. Relationships between these common insulin-resistant conditions, however, remain unclear. We conducted a secondary analysis of the Australian Longitudinal Study on Women's Health (ALSWH) database, including data from 8009 women aged 18-36 years across six surveys. We used latent-curve growth modelling to identify distinct body mass index (BMI) trajectories and multinomial logistic regression to explore sociodemographic and health variables characterizing BMI group membership. Logistic regression was used to assess independent risk of GDM. A total of 662 women (8.29%, 95% CI 7.68-8.89) reported PCOS. Three distinct BMI trajectories emerged, namely low stable (LSG) (63.8%), defined as an average trajectory remaining at ~25 kg/m(2); moderately rising (MRG) (28.8%), a curvilinear trajectory commencing in a healthy BMI and terminating in the overweight range; and high-rising (HRG) (7.4%), a curvilinear trajectory starting and terminating in the obese range. A high BMI in early reproductive life predicted membership in higher trajectories. The HRG BMI trajectory was independently associated with GDM (OR 2.50, 95% CI 1.80-3.48) and was a stronger correlate than PCOS (OR 1.89, 95% CI 1.41-2.54), maternal age, socioeconomic status, or parity. Our results suggest heterogeneity in BMI change among Australian women of reproductive age, with and without PCOS. Reducing early adult life weight represents an ideal opportunity to intervene at an early stage of reproductive life and decreases the risk of long-term metabolic complications such as GDM.

  13. The UK Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group, Report 2: real-world data for the impact of cataract surgery on diabetic macular oedema.

    Science.gov (United States)

    Denniston, Alastair K; Chakravarthy, Usha; Zhu, Haogang; Lee, Aaron Y; Crabb, David P; Tufail, Adnan; Bailey, Clare; Akerele, Toks; Al-Husainy, Sahar; Brand, Christopher; Downey, Louise; Fitt, Alan; Khan, Rehna; Kumar, Vineeth; Lobo, Aires; Mahmood, Sajjad; Mandal, Kaveri; Mckibbin, Martin; Menon, Geeta; Natha, Salim; Ong, Jong Min; Tsaloumas, Marie D; Varma, Atul; Wilkinson, Elizabeth; Johnston, Robert L; Egan, Catherine A

    2017-12-01

    To assess the rate of 'treatment-requiring diabetic macular oedema (DMO)' in eyes for the two  years before and after cataract surgery. Multicentre national diabetic retinopathy (DR) database study with anonymised data extraction across 19 centres from an electronic medical record system. eyes undergoing cataract surgery in patients with diabetes with no history of DMO prior to study start. The minimum dataset included: age, visual acuity (all time-points), injection episodes, timing of cataract surgery and ETDRS grading of retinopathy and maculopathy. rate of developing first episode of treatment-requiring DMO in relation to timing of cataract surgery in the same eye. 4850 eyes met the inclusion criteria. The rate of developing treatment-requiring DMO in this cohort was 2.9% in the year prior to surgery versus 5.3% in the year after surgery (pdiabetic retinopathy; NPDR), 10.0% (moderate NPDR), 13.1% (severe NPDR) and 4.9% (PDR) (p<0.01). This large real-world study demonstrates that the rate of developing treatment-requiring DMO increases sharply in the year after cataract surgery for all grades of retinopathy, peaking in the 3-6 months' postoperative period. Patients with moderate and severe NPDR are at particularly high risk. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Participants' perceptions of a group based program incorporating hands-on meal preparation and pedometer-based self-monitoring in type 2 diabetes.

    Science.gov (United States)

    Dasgupta, Kaberi; Jarvandi, Soghra; De Civita, Mirella; Pillay, Sabrina; Hajna, Samantha; Gougeon, Rejeanne; Bader, Abeer; Da Costa, Deborah

    2014-01-01

    Nutrition education (portion sizes, balanced meals) is a cornerstone of diabetes management; however, moving from information to behavior change is challenging. Through a single arm intervention study, we recently demonstrated that combining education with group-based meal preparation training has measureable effects on weight, eating behaviour, and glycemic control in adults with type 2 diabetes. In the present study, we conducted an in-depth examination of participants' perceptions of this strategy, through focus group discussion, to delineate effective elements of the strategy from participants' perspectives. Participants who had completed the nutrition education/meal preparation training program were invited to attend one of four focus group discussions. These were led by experienced facilitators and guided by questions addressing experiences during the intervention and their perceived impact. Audiotapes were transcribed and qualitative content analysis of transcripts was performed. We report herein themes that achieved saturation across the four discussions. Twenty-nine (80.6%, 29/36) attended a focus group discussion. The program elements perceived as effective by participants included the hands-on interactive learning approach to meal preparation, the grocery store tour, pedometer-based self-monitoring, experiencing the link between food consumption/physical activity and glucose changes during the program, and peer support. Discussants reported changes in eating and walking behaviour, greater confidence in ability to self-manage diabetes, reductions in glucose levels and/or need for glucose-lowering medications, and, in some cases, weight loss. Family members and friends were facilitators for some and barriers for others in terms of achieving health behavior changes. Among adults with type 2 diabetes, a group based program that included hands-on meal preparation and pedometer-based self-monitoring was perceived as effective in conveying information

  15. Participants' perceptions of a group based program incorporating hands-on meal preparation and pedometer-based self-monitoring in type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Kaberi Dasgupta

    Full Text Available Nutrition education (portion sizes, balanced meals is a cornerstone of diabetes management; however, moving from information to behavior change is challenging. Through a single arm intervention study, we recently demonstrated that combining education with group-based meal preparation training has measureable effects on weight, eating behaviour, and glycemic control in adults with type 2 diabetes. In the present study, we conducted an in-depth examination of participants' perceptions of this strategy, through focus group discussion, to delineate effective elements of the strategy from participants' perspectives.Participants who had completed the nutrition education/meal preparation training program were invited to attend one of four focus group discussions. These were led by experienced facilitators and guided by questions addressing experiences during the intervention and their perceived impact. Audiotapes were transcribed and qualitative content analysis of transcripts was performed. We report herein themes that achieved saturation across the four discussions.Twenty-nine (80.6%, 29/36 attended a focus group discussion. The program elements perceived as effective by participants included the hands-on interactive learning approach to meal preparation, the grocery store tour, pedometer-based self-monitoring, experiencing the link between food consumption/physical activity and glucose changes during the program, and peer support. Discussants reported changes in eating and walking behaviour, greater confidence in ability to self-manage diabetes, reductions in glucose levels and/or need for glucose-lowering medications, and, in some cases, weight loss. Family members and friends were facilitators for some and barriers for others in terms of achieving health behavior changes.Among adults with type 2 diabetes, a group based program that included hands-on meal preparation and pedometer-based self-monitoring was perceived as effective in conveying

  16. Comparison of quality of life in a group of Lebanese type 1 diabetics on insulin pump and those on multiple daily injections.

    Science.gov (United States)

    Bayrakdar, Amani; Noureddine, Samar; Farhood, Laila; Nasrallah, Mona P

    2014-01-01

    The aim of the study is to investigate the differences in the quality of life (QOL) in Lebanese youths with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) and those using multiple daily injections (MDI) treatment modalities. A descriptive, cross-sectional, comparative matched design was used. The sample included 36 adolescents and young adults on one of two treatment modalities (CSII or MDI) and matched for age, gender, and level of education. QOL was measured with the Indiana Diabetes Quality of Life for Youth and latest HbA1C level was recorded. The CSII group had significantly lower HbA1C levels (p life (p = 0.002), less impact of the disease (p = 0.002), and fewer worries about their disease (p = 0.029), compared to the MDI group. The overall quality of life score was also significantly better in the CSII group than in the MDI group (p = 0.001). Findings suggest that CSII is associated with better glycemic control and QOL in the Lebanese youth population with type 1 diabetes.

  17. Prevalence of Eligibility Criteria for the Systolic Blood Pressure Intervention Trial in US Adults Among Excluded Groups: Age Diabetes Mellitus, or a History of Stroke.

    Science.gov (United States)

    Bress, Adam P; Tanner, Rikki M; Hess, Rachel; Gidding, Samuel S; Colantonio, Lisandro D; Shimbo, Daichi; Muntner, Paul

    2016-07-12

    Adults diabetes mellitus, or a history of stroke were not enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Estimating the size and characteristics of these excluded groups who meet the other SPRINT eligibility criteria may provide information on the potential impact of providers extending the SPRINT findings to these populations. We analyzed the National Health and Nutrition Examination Survey 2003-2012 (n=25 076) to estimate the percentage and characteristics of US adults ≥20 years in 3 populations (age diabetes mellitus, or history of stroke) excluded from SPRINT who otherwise meet the trial eligibility criteria: age ≥50 years, systolic blood pressure (SBP) 130-180 mm Hg, high cardiovascular disease risk, and not having trial exclusion criteria. Overall, 1.0% (95% CI 0.8-1.3) of US adults age diabetes mellitus, and 19.0% (95% CI 16.0-22.4) with history of stroke met the other SPRINT eligibility criteria. Among US adults with SBP ≥130 mm Hg, other SPRINT eligibility criteria were met by 7.5% (95% CI 6.1-9.2) of those age diabetes mellitus, and 23.0% (95% CI 19.4-27.0) with history of stroke. Among US adults meeting the other SPRINT eligibility criteria, antihypertensive medication was being taken by 31.0% (95% CI 23.9-41.3) of those diabetes mellitus, and 68.9% (95% CI 59.4-77.1) with a history of stroke. A substantial percentage of US adults with diabetes mellitus or history of stroke and a small percentage <50 years old meet the other SPRINT eligibility criteria. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. Effect of the diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups on the prevalence of gestational diabetes mellitus in urban Mexican women: a cross-sectional study.

    Science.gov (United States)

    Reyes-Muñoz, Enrique; Parra, Adalberto; Castillo-Mora, Alfredo; Ortega-González, Carlos

    2012-01-01

    To explore the prevalence of gestational diabetes mellitus (GDM), defined by the previous criteria of the American Diabetes Association (ADA), as well as the criteria suggested by the International Association of Diabetes and Pregnancy Study Groups (IADPSG), in an unselected group of urban Mexican pregnant women and to analyze the frequency of large for gestational age (LGA) newborns in this same group of women with use of both diagnostic criteria. A cross-sectional study included 803 consecutive Mexican urban women with a singleton pregnancy, without concomitant diseases and no prior history of GDM, who underwent a 2-step screening protocol for diagnosis of GDM at admission to prenatal care. The ADA criteria identified 83 women (10.3%) whereas the IADPSG criteria diagnosed 242 women (30.1%) having GDM (P = .0001). Fasting glucose concentrations during the 100-g 3-hour oral glucose tolerance test were abnormal in 116 women (14.4%) and in 160 women (19.9%) on the basis of ADA and IADPSG criteria, respectively (P = .004). The frequency of LGA newborns was 7.4% based on IADPSG criteria and 6.0% based on ADA criteria-no significant difference (P = .64). With use of the IADPSG criteria, the prevalence of GDM increased almost 3-fold in comparison with that for the ADA criteria. Nevertheless, no significant difference was found in the prevalence of LGA newborns.

  19. Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients.

    Science.gov (United States)

    Ashur, S T; Shamsuddin, K; Shah, S A; Bosseri, S; Morisky, D E

    2015-12-13

    No validation study has previously been made for the Arabic version of the 8-item Morisky Medication Adherence Scale (MMAS-8(©)) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya. A convenience sample of 103 patients self-completed the questionnaire. Reliability was tested using Cronbach alpha, average inter-item correlation and Spearman-Brown coefficient. Known-group validity was tested by comparing MMAS-8 scores of patients grouped by glycaemic control. The Arabic version showed adequate internal consistency (α = 0.70) and moderate split-half reliability (r = 0.65). Known-group validity was supported as a significant association was found between medication adherence and glycaemic control, with a moderate effect size (ϕc = 0.34). The Arabic version displayed good psychometric properties and could support diabetes research and practice in Arab countries.

  20. Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States

    Directory of Open Access Journals (Sweden)

    Rupal M. Patel

    2017-01-01

    Full Text Available This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM among Gujarati Asian Indians (AIs in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n=34 or a control group (n=36 that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p<0.0005 and waist circumference (p=0.04 significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US.

  1. Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups : A case study

    NARCIS (Netherlands)

    Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, H.J.M.

    2015-01-01

    Background Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two

  2. The association of handgrip strength and type 2 diabetes mellitus in six ethnic groups : An analysis of the HELIUS study

    NARCIS (Netherlands)

    Van Der Kooi, Anne Lotte L F; Snijder, Marieke B.; Peters, Ron J G; Van Valkengoed, Irene G M

    2015-01-01

    We investigated whether ethnic differences in handgrip strength, a marker of poor muscle strength and quality, is a potential cause of ethnic disparities in type 2 diabetes mellitus. We included 2086 Dutch, 2216 South Asian Surinamese, 2084 African Surinamese, 1786 Ghanaian, 2223 Turkish and 2199

  3. The Association of Handgrip Strength and Type 2 Diabetes Mellitus in Six Ethnic Groups: An Analysis of the HELIUS Study

    NARCIS (Netherlands)

    van der Kooi, Anne-Lotte L. F.; Snijder, Marieke B.; Peters, Ron J. G.; van Valkengoed, Irene G. M.

    2015-01-01

    We investigated whether ethnic differences in handgrip strength, a marker of poor muscle strength and quality, is a potential cause of ethnic disparities in type 2 diabetes mellitus. We included 2086 Dutch, 2216 South Asian Surinamese, 2084 African Surinamese, 1786 Ghanaian, 2223 Turkish and 2199

  4. Diabetes-ameliorating effects of fermented red ginseng and causal effects on hormonal interactions: testing the hypothesis by multiple group path analysis.

    Science.gov (United States)

    Lee, Kwang Jo; Lee, Sook Yeon; Ji, Geun Eog

    2013-05-01

    Although diagnostic criteria for metabolic syndrome (MtS) vary among various health professionals and organizations, blood glucose dysregulation and insulin resistance are common to all definitions. Red ginseng is beneficial for glucose regulation and insulin sensitivity but the mechanism is not yet elucidated. Ginsenosides Rh1 and Rg3 act as ligands of the estrogen receptor, and Rh2 and compound K act as ligands of the glucocorticoid receptors, which may influence the diabetes markers. The objective of this study was to test the hypothesis that there are significant causal relationships among diabetes-related markers and several hormones, and assess whether or not the consumption of fermented red ginseng (FRG) influences these causal relationships by multiple group path analysis and conventional statistical analyses. The 93 postmenopausal women were randomly divided into two groups for a double-blind trial. FRG powder and placebo were provided for 2 weeks. The data were analyzed by multiple group path analysis and the mean between groups were compared. The model's goodness of fit was excellent, with a root mean square error of approximation of 0.00, and comparative fit index of 1.00. The FRG group exhibited significantly increased levels of dehydroepiandrosterone sulfate (DHEAS), growth hormone (GH), and estradiol (E2), and they exhibited decreased levels of glycosylated hemoglobin (HbA1c), insulin, and homeostatic model assessment of insulin resistance. With regard to the hypothesis, the blood glucose lowering effects of FRG were due to the negative effects of aldosterone and increased GH, which was associated with DHEAS and E2. Even though the differences of variables between both groups were small, the total effects of these variables may indicate beneficial changes for the prevention of diabetes in healthy postmenopausal women.

  5. Elevated Fasting Blood Glucose Is Predictive of Poor Outcome in Non-Diabetic Stroke Patients: A Sub-Group Analysis of SMART.

    Science.gov (United States)

    Yao, Ming; Ni, Jun; Zhou, Lixin; Peng, Bin; Zhu, Yicheng; Cui, Liying

    2016-01-01

    Although increasing evidence suggests that hyperglycemia following acute stroke adversely affects clinical outcome, whether the association between glycaemia and functional outcome varies between stroke patients with\\without pre-diagnosed diabetes remains controversial. We aimed to investigate the relationship between the fasting blood glucose (FBG) and the 6-month functional outcome in a subgroup of SMART cohort and further to assess whether this association varied based on the status of pre-diagnosed diabetes. Data of 2862 patients with acute ischemic stroke (629 with pre-diagnosed diabetics) enrolled from SMART cohort were analyzed. Functional outcome at 6-month post-stroke was measured by modified Rankin Scale (mRS) and categorized as favorable (mRS:0-2) or poor (mRS:3-5). Binary logistic regression model, adjusting for age, gender, educational level, history of hypertension and stroke, baseline NIHSS and treatment group, was used in the whole cohort to evaluate the association between admission FBG and functional outcome. Stratified logistic regression analyses were further performed based on the presence/absence of pre-diabetes history. In the whole cohort, multivariable logistical regression showed that poor functional outcome was associated with elevated FBG (OR1.21 (95%CI 1.07-1.37), p = 0.002), older age (OR1.64 (95% CI1.38-1.94), pimportance of glycemic control during acute phase of ischemic stroke especially in patients without pre-diagnosed diabetes. Further investigation for developing optimal strategies to control blood glucose level in hyperglycemic setting is therefore of great importance. ClinicalTrials.gov NCT00664846.

  6. The development of 'Quality of Life Instrument for Indian Diabetes patients (QOLID): a validation and reliability study in middle and higher income groups.

    Science.gov (United States)

    Nagpal, Jitender; Kumar, Arvind; Kakar, Sonia; Bhartia, Abhishek

    2010-05-01

    To develop a reliable and valid quality of life questionnaire for Indian patients with diabetes. A draft of 75 questions was prepared on the basis of expert opinion, focus group discussions, review of existing literature and detailed semi-structured interviews of patients with diabetes with the intention of including all aspects of diabetes-specific and quality of life considered relevant by patients and care providers to enable constrict validity. A Stage 2 questionnaire was then prepared with 13 domains and 54 items (questions) after expert panel review for obvious irrelevance and duplication of issues. It was administered to 150 participants visiting a diabetes center at New Delhi. Factor analysis was done using principal component method with varimax rotation. Reliability analysis was done by calculating Cronbach's Alpha. For evaluating concordant validity the questionnaire was co-administered with DQL-CTQ to 30 participants. The discriminant validity of the questionnaire was tested using 't' test for metabolic control, co-morbidities, insulin use and gender. Using principal component method 8 domains were identified on the basis of an apriori hypothesis and the scree plot. These 8 domains explained 49.9% of the total variation. 34 items (questions) were selected to represent these domains on the basis of extraction communality, factor loading, inter-item and item-total correlations. The final questionnaire has an Overall Cronbach's Alpha value of 0.894 (subscale- 0.55 to 0.85) showing high internal consistency. The questionnaire showed good concordance (product moment correlation 0.724; p = 0.001; subscale correlation - 0.457 to 0.779) with the DQL-CTQ. The overall standardized questionnaire score showed good responsiveness to metabolic control and co-morbidities establishing discriminant validity. The final version of questionnaire with 8 domains and 34 items is a reliable and valid tool for assessment of quality of life of Indian patients with diabetes.

  7. Control group characteristics and study outcomes: empirical data from a study on mortality of patients with type 2 diabetes mellitus in Dutch general practice.

    Science.gov (United States)

    de Grauw, W J; van den Hoogen, H J; van de Lisdonk, E H; van Gerwen, W H; van Weel, C

    1998-04-01

    Control group characteristics as comorbidity and chronic psychosocial problems may play an important part in study outcomes. A primary care data base was used to quantify the effects of varying the case mix of participants. Historical cohort study. Data were collected from 1967-1996 in four Dutch general practices performing the Continuous Morbidity Registration Nijmegen. All newly diagnosed type 2 diabetic patients in the period 1967-1989 fulfilling the WHO criteria (n = 265); for each type 2 diabetic patient a control was matched for practice, sex, age, and social class; from these controls subgroups were selected based on the absence of different types of morbidity; these subgroups were also matched for practice, sex, age, and social class. The relative risk of mortality in type 2 diabetic patients in comparison with various subsets of controls ranged from 1.33 (95% CI 0.97, 1.81) to 2.16 (95% CI 1.46, 3.20). Control group characteristics as comorbidity and chronic psychosocial problems turned out to influence the risk estimation in a cohort study. General practice data enhance the study of these aspects.

  8. Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States.

    Science.gov (United States)

    Patel, Rupal M; Misra, Ranjita; Raj, Sudha; Balasubramanyam, Ashok

    2017-01-01

    This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM) among Gujarati Asian Indians (AIs) in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c) and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n = 34) or a control group (n = 36) that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p Gujarati AIs living in the US.

  9. HBA1C AND LIPID PROFILE LEVELS IN THE KNOWN TYPE 2 DIABETIC GROUP IN THE RURAL REGION OF VIDARBHA, MAHARASHTRA, INDIA

    Directory of Open Access Journals (Sweden)

    Sarmistha Sarkar

    2017-04-01

    Full Text Available BACKGROUND Diabetes Mellitus (DM is a group of metabolic diseases in which there is high blood sugar levels over a prolonged period of time, and if early interventions are not taken, then it can cause many life-threatening complications like heart disease, stroke, kidney failure, damage to eyes, etc. Our aim is to determine HbA1c and Lipid profile level in the known type 2 diabetic group in the rural region of Vidarbha, Maharashtra, India, to see that as our study is a rural-based study and there is less pollution and stress factor compared to the cities whether it effects out study result or not. MATERIALS AND METHODS FBS, HbA1c, TC, HDL, LDL, VLDL, TG levels were evaluated. Total sample size 60 in between 30-40 years including males and females divided into two groups. 30 patients study group with known history of type 2 DM who attended the Medicine OPD and 30 age, sex matched healthy controls. Statistical analysis was done by using SPSS 17.0 version. RESULTS Results of serum lipid profile showed that mean values for TC, TG, HDL, LDL and VLDL in study group were 227.76±30.72, 152.23 ± 40.94, 40.5 ± 6.43, 153.30 ± 27.70 and 33.00 ± 9.94 mg/dL. FBS showed significant positive correlation with HbA1c (p<0.002. HDL has significant negative correlation with HbA1c (p<0.008. CONCLUSION Early detection in the abnormalities of serum lipid profile and HbA1c can minimise the risk for micro and macroangiopathies in the known type 2 diabetic patients.

  10. Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain.

    Science.gov (United States)

    Simpson, Richard W; Wlodarczyk, John H

    2016-09-01

    To evaluate the efficacy and safety of transdermal buprenorphine in patients with diabetic peripheral neuropathic pain (DPNP). This multicenter, randomized, double-blind, placebo-controlled, parallel-group trial enrolled patients with type 1 or type 2 diabetes and stable glycemic control who had been experiencing moderate to severe DPNP for at least 6 months on maximal tolerated conventional therapy. Patients were randomly assigned to receive buprenorphine (5 μg/h) or placebo patches. The dose was titrated to effect to a maximum of 40 μg/h. Paracetamol was available as rescue analgesia. The severity of pain and other symptoms of DPNP were assessed daily in a patient diary and at clinic visits. One hundred eight-six patients were enrolled, with 93 randomized to either buprenorphine or placebo. A high proportion of patients did not complete the study (buprenorphine 37 of 93, placebo 24 of 93). The main reason for premature withdrawal in the buprenorphine group was adverse events commonly due to untreated nausea and/or vomiting. Among the per-protocol population, more patients in the buprenorphine group (86.3%) experienced a 30% reduction in average versus baseline pain at week 12 than those in the placebo group (56.6%, P buprenorphine group within the intention-to-treat analysis of the same end point (51.7% vs. 41.3%, P = 0.175). Transdermal buprenorphine, when tolerated, is an effective therapy for DPNP and provides another option to manage this challenging painful condition. Nausea and constipation need to be managed proactively to optimize treatment outcomes. © 2016 by the American Diabetes Association.

  11. Cyclosporin A treatment of young children with newly-diagnosed type 1 (insulin-dependent) diabetes mellitus. London Diabetes Study Group.

    Science.gov (United States)

    Jenner, M; Bradish, G; Stiller, C; Atkison, P

    1992-09-01

    Several studies have demonstrated the efficacy of cyclosporin A in modifying the initial course of Type 1 (insulin-dependent) diabetes mellitus in older children and adults but none have reported the effects in very young children. We treated 14 newly-diagnosed Type 1 diabetic patients aged 22 months to 95 months with cyclosporin A. Mean insulin dose at entry was 0.7 +/- 0.07 IU.kg-1.day-1. Initial cyclosporin A dose was 10 mg.kg-1.day-1. Insulin dose reached a nadir of 0.13 IU.kg-1.day-1 by 180 days. Mean glucagon-stimulated connecting peptide levels were maximal at 6 months (0.75 nmol/l) and were maintained while on cyclosporin A. Insulin was discontinued in four patients for 4, 12, 15 and 30 months respectively. In five other patients the insulin dose was less than 0.15 IU.kg-1.day-1 for at least 3 months. Glycated haemoglobin levels for all patients were within the normal range. Side effects included anorexia, stomach pains, poor weight gain, hypertrichosis, gum hyperplasia, mild anaemia and elevated creatinine. All patients have now discontinued cyclosporin A and all but one have been followed for 5 years after discontinuation. Reasons for discontinuing cyclosporin A included exposure to chicken pox (varicella), non-resolving otitis media, incomplete or no response and relapse. All side effects have resolved since the treatment was discontinued. Following discontinuation of cyclosporin A insulin requirements and glycated hemoglobin levels increased while glucagon-stimulated connecting peptide levels declined dramatically.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. The Irish DAFNE study protocol: a cluster randomised trial of group versus individual follow-up after structured education for type 1 diabetes.

    LENUS (Irish Health Repository)

    Dinneen, Seán F

    2009-01-01

    BACKGROUND: Structured education programmes for individuals with Type 1 diabetes have become a recognised means of delivering the knowledge and skills necessary for optimal self-management of the condition. The Dose Adjustment for Normal Eating (DAFNE) programme has been shown to improve biomedical (HbA(1c) and rates of severe hypoglycaemia) and psychosocial outcomes for up to 12 months following course delivery. The optimal way to support DAFNE graduates and maintain the benefits of the programme has not been established. We aimed to compare 2 different methods of follow-up of DAFNE graduates in a pragmatic clinical trial delivered in busy diabetes clinics on the island of Ireland. METHODS: Six participating centres were cluster randomised to deliver either group follow-up or a return to traditional one-to-one clinic visits. In the intervention arm group follow-up was delivered at 6 and 12 months post DAFNE training according to a curriculum developed for the study. In the control arm patients were seen individually in diabetes clinics as part of routine care. Study outcomes included HbA(1c) levels, self-reported rates of severe hypoglycaemia, body weight and measures of diabetes wellbeing and quality of life. These were measured at 6, 12 and 18 months after recruitment. Generalisability (external validity) was maximised by recruiting study participants from existing DAFNE waiting lists in each centre, by using broad inclusion criteria (including HbA(1c) values less than 13 percent with no lower limit) and by using existing clinic staff to deliver the training and follow-up. Internal validity and treatment fidelity were maximised by quality assuring the training of all DAFNE educators, by external peer review of the group follow-up sessions and by striving for full attendance at follow-up visits. Assays of HbA(1c) were undertaken in a central laboratory. DISCUSSION: This pragmatic clinical trial evaluating group follow-up after a structured education programme has

  13. Study protocol of the Diabetes and Depression Study (DAD): a multi-center randomized controlled trial to compare the efficacy of a diabetes-specific cognitive behavioral group therapy versus sertraline in patients with major depression and poorly controlled diabetes mellitus

    Science.gov (United States)

    2013-01-01

    Background Depression is common in diabetes and associated with hyperglycemia, diabetes related complications and mortality. No single intervention has been identified that consistently leads to simultaneous improvement of depression and glycemic control. Our aim is to analyze the efficacy of a diabetes-specific cognitive behavioral group therapy (CBT) compared to sertraline (SER) in adults with depression and poorly controlled diabetes. Methods/Design This study is a multi-center parallel arm randomized controlled trial currently in its data analysis phase. We included 251 patients in 70 secondary care centers across Germany. Key inclusion criteria were: type 1 or 2 diabetes, major depression (diagnosed with the Structured Clinical Interview for DSM-IV, SCID) and hemoglobin A1C >7.5% despite current insulin therapy. During the initial phase, patients received either 50–200 mg/d sertraline or 10 CBT sessions aiming at the remission of depression and enhanced adherence to diabetes treatment and coping with diabetes. Both groups received diabetes treatment as usual. After 12 weeks of this initial open-label therapy, only the treatment-responders (50% depression symptoms reduction, Hamilton Depression Rating Scale, 17-item version [HAMD]) were included in the subsequent one year study phase and represented the primary analysis population. CBT-responders received no further treatment, while SER-responders obtained a continuous, flexible-dose SER regimen as relapse prevention. Adherence to treatment was analyzed using therapeutic drug monitoring (measurement of sertraline and N-desmethylsertraline concentrations in blood serum) and by counting the numbers of CBT sessions received. Outcome assessments were conducted by trained psychologists blinded to group assignment. Group differences in HbA1c (primary outcome) and depression (HAMD, secondary outcome) between 1-year follow-up and baseline will be analyzed by ANCOVA controlling for baseline values. As primary

  14. Oral insulin administration and residual beta-cell function in recent-onset type 1 diabetes: a multicentre randomised controlled trial. Diabète Insuline Orale group.

    Science.gov (United States)

    Chaillous, L; Lefèvre, H; Thivolet, C; Boitard, C; Lahlou, N; Atlan-Gepner, C; Bouhanick, B; Mogenet, A; Nicolino, M; Carel, J C; Lecomte, P; Maréchaud, R; Bougnères, P; Charbonnel, B; Saï, P

    2000-08-12

    Oral administration of autoantigens can slow the progression of beta-cell destruction in non-obese diabetic mice. We investigated whether oral administration of recombinant human insulin could protect residual beta-cell function in recent-onset type 1 diabetes. We enrolled 131 autoantibody-positive diabetic patients aged 7-40 years within 2 weeks of diagnosis (no ketoacidosis at diagnosis, weight loss insulin daily or placebo for 1 year, in addition to subcutaneous insulin therapy. Serum C-peptide concentrations were measured in the fasting state and after stimulation, to assess beta-cell function. Autoantibodies to beta-cell antigens were assayed. Analyses were by intention to treat. Baseline C-peptide and haemoglobin A1c concentrations were similar in the three groups. During follow-up, there were no differences between the groups assigned 2.5 mg or 7.5 mg oral insulin or placebo in subcutaneous insulin requirements, haemoglobin A1c concentrations, or measurements of fasting (mean at 12 months 0.18 [SD 0.17], 0.17 [0.17], and 0.17 [0.12] nmol/L) or stimulated C-peptide concentrations (glucagon-stimulated 0.39 [0.38], 0.37 [0.39], and 0.33 [0.24] nmol/L; meal-stimulated 0.72 [0.60], 0.49 [0.49], and 0.57 [0.51 nmol/L]. Neither age nor C-peptide concentration at entry influenced treatment effects. No differences were seen in the time-course or titres of antibodies to insulin, glutamic acid decarboxylase, or islet antigen 2. At the doses used in this trial, oral administration of insulin initiated at clinical onset of type 1 diabetes did not prevent the deterioration of beta-cell function.

  15. Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM? Findings from a Randomized Control Mixed Methods Trial

    Directory of Open Access Journals (Sweden)

    Angela O’Dea

    2015-01-01

    Full Text Available Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM. Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24 or wait control (n=26 and postintervention qualitative interviews with participants. Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG from study entry to one-year follow-up. Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance. Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

  16. Lifestyle risk factors for cardiovascular disease and diabetic risk in a sedentary occupational group: the Galway taxi driver study.

    Science.gov (United States)

    Martin, W P; Sharif, F; Flaherty, G

    2016-05-01

    Taxi drivers are at increased risk of cardiovascular disease (CVD), something which persists after correcting for the overrepresentation of traditional risk factors for CVD in this cohort. The contribution of lifestyle risk factors to this residually elevated CVD risk remains under-evaluated. We aimed to determine the prevalence of lifestyle risk factors for CVD, self-reported medical risk factors for CVD, and future risk of type 2 diabetes amongst Irish taxi drivers. Male taxi drivers with no history of CVD and type 2 diabetes and working in Galway city in the west of Ireland were invited to participate. Physical activity levels, dietary patterns, anthropometry, smoking, hypertension, hypercholesterolaemia, and Finnish Diabetes Risk Score (FINDRISC) values were recorded in a cross-sectional manner. 41 taxi drivers (mean age 56.7 ± 9.8 years) participated. 37 % were insufficiently active based on self-report, although only 8 % objectively achieved 10, 000 steps per day. Mean modified Mediterranean diet score (mMDS) was 4.6 ± 2.2, and only 13 % of participants had a normal body mass index (BMI) or waist circumference (WC). Those who worked for taxi companies tended to have a higher BMI (p = .07) and WC (p = .04) by multivariable regression. 22 % were current smokers, although a quit rate of 72 % was observed amongst the 78 % of taxi drivers who had ever smoked. 25 % were at high or very high risk of future type 2 diabetes. Lifestyle risk factors for CVD and dysglycaemia are prevalent amongst Irish taxi drivers.

  17. The Correlation of Lab Data, Hormone Peptides, Quality of Life, and Different Traditional Chinese Medicine Syndrome Groups in Type 2 Diabetes Patients

    Directory of Open Access Journals (Sweden)

    Ching-Min Luo

    2013-04-01

    Full Text Available The aim of this study is to explore the correlation of laboratory data, hormone peptides, and quality of life with different traditional Chinese medicine (TCM syndrome groups in type 2 diabetes patients. Of 513 registered patients, 179 subjects aged between 20 and 65 years and having type 2 diabetes mellitus (T2DM for more than 1 year were enrolled in the study. All the participants were asked to fill out a questionnaire on diabetic TCM syndrome groups, which was designed by professional TCM doctors, and two questionnaires on the quality of life (QOL, WHOQOL-BREF Taiwan version and Medical Outcomes Study (MOS Short Form-12 (SF-12. The biochemical characteristics and hormone peptide levels were collected at the same time. The patients in any one of the six TCM syndrome groups had the trend to have worse QOL. Especially, patients with qi deficiency had worse life quality on every aspect compared to those without qi deficiency and were fatter than others. We also found that the subjects who had qi deficiency, qi stagnation, and yin deficiency at the same time had worsened condition. We consider that patients with qi deficiency may also be at a higher risk of developing other complications. They need more advanced health care than others. This self-reported questionnaire will be a reference for health care workers screening those T2DM patients who have a higher possibility of developing other complications. Especially in remote areas, where there is a lack of medical resources, an easy-to-use tool such as the one in the present study for detecting and evaluating disease conditions is needed.

  18. Succination of thiol groups in adipose tissue proteins in diabetes: succination inhibits polymerization and secretion of adiponectin.

    Science.gov (United States)

    Frizzell, Norma; Rajesh, Mathur; Jepson, Matthew J; Nagai, Ryoji; Carson, James A; Thorpe, Suzanne R; Baynes, John W

    2009-09-18

    S-(2-Succinyl)cysteine (2SC) is formed by reaction of the Krebs cycle intermediate fumarate with cysteine residues in protein, a process termed succination of protein. Both fumarate and succination of proteins are increased in adipocytes cultured in high glucose medium (Nagai, R., Brock, J. W., Blatnik, M., Baatz, J. E., Bethard, J., Walla, M. D., Thorpe, S. R., Baynes, J. W., and Frizzell, N. (2007) J. Biol. Chem. 282, 34219-34228). We show here that succination of protein is also increased in epididymal, mesenteric, and subcutaneous adipose tissue of diabetic (db/db) mice and that adiponectin is a major target for succination in both adipocytes and adipose tissue. Cys-39, which is involved in cross-linking of adiponectin monomers to form trimers, was identified as a key site of succination of adiponectin in adipocytes. 2SC was detected on two of seven monomeric forms of adiponectin immunoprecipitated from adipocytes and epididymal adipose tissue. Based on densitometry, 2SC-adiponectin accounted for approximately 7 and 8% of total intracellular adiponectin in cells and tissue, respectively. 2SC was found only in the intracellular, monomeric forms of adiponectin and was not detectable in polymeric forms of adiponectin in cell culture medium or plasma. We conclude that succination of adiponectin blocks its incorporation into trimeric and higher molecular weight, secreted forms of adiponectin. We propose that succination of proteins is a biomarker of mitochondrial stress and accumulation of Krebs cycle intermediates in adipose tissue in diabetes and that succination of adiponectin may contribute to the decrease in plasma adiponectin in diabetes.

  19. Genome-wide linkage scans for type 2 diabetes mellitus in four ethnically diverse populations; significant evidence for linkage on chromosome 4q in African Americans: the Family Investigation of Nephropathy and Diabetes (FIND) Research Group

    Science.gov (United States)

    Malhotra, Alka; Igo, Robert P.; Thameem, Farook; Kao, W.H. Linda; Abboud, Hanna E.; Adler, Sharon G.; Arar, Nedal H.; Bowden, Donald W.; Duggirala, Ravindranath; Freedman, Barry I.; Goddard, Katrina A.B.; Ipp, Eli; Iyengar, Sudha K.; Kimmel, Paul L.; Knowler, William C.; Kohn, Orly; Leehey, David; Meoni, Lucy A.; Nelson, Robert G.; Nicholas, Susanne B.; Parekh, Rulan S.; Rich, Stephen S.; Chen, Yii-Der I.; Saad, Mohammed F.; Scavini, Marina; Schelling, Jeffrey R.; Sedor, John R.; Shah, Vallabh O.; Taylor, Kent D.; Thornley-Brown, Denyse; Zager, Philip G.; Horvath, Amanda; Hanson, Robert L.

    2009-01-01

    Background Previous studies have shown that, in addition to environmental influences, type 2 diabetes mellitus (T2DM) has a strong genetic component. The goal of the current study is to identify regions of linkage for T2DM in ethnically diverse populations. Methods Phenotypic and genotypic data were obtained from African American (AA; total number of individuals (N)=1004), American Indian (AI; N=883), European American (EA; N=537), and Mexican American (MA; N=1634) individuals from the Family Investigation of Nephropathy and Diabetes. Nonparametric linkage analysis, using an average of 4,404 SNPs, was performed in relative pairs affected with T2DM in each ethnic group. In addition, family-based tests were performed to detect association with T2DM. Results Statistically significant evidence for linkage was observed on chromosomes 4q21.1 (LOD=3.13; genome-wide p=0.04) in AA. In addition, a total of eleven regions showed suggestive evidence for linkage (estimated at LOD>1.71), with the highest LOD scores on chromosomes 12q21.31 (LOD=2.02) and 22q12.3 (LOD=2.38) in AA, 2p11.1 (LOD=2.23) in AI, 6p12.3 (LOD=2.77) in EA, and 13q21.1 (LOD=2.24) in MA. While no region overlapped across all ethnic groups, at least five loci showing LOD>1.71 have been identified in previously published studies. Conclusions The results from this study provide evidence for the presence of genes affecting T2DM on chromosomes 4q, 12q, and 22q in AA, 6p in EA, 2p in AI, and 13q in MA. The strong evidence for linkage on chromosome 4q in AA provides important information given the paucity of diabetes genetic studies in this population. PMID:19795399

  20. Genome-wide linkage scans for type 2 diabetes mellitus in four ethnically diverse populations-significant evidence for linkage on chromosome 4q in African Americans: the Family Investigation of Nephropathy and Diabetes Research Group.

    Science.gov (United States)

    Malhotra, Alka; Igo, Robert P; Thameem, Farook; Kao, W H Linda; Abboud, Hanna E; Adler, Sharon G; Arar, Nedal H; Bowden, Donald W; Duggirala, Ravindranath; Freedman, Barry I; Goddard, Katrina A B; Ipp, Eli; Iyengar, Sudha K; Kimmel, Paul L; Knowler, William C; Kohn, Orly; Leehey, David; Meoni, Lucy A; Nelson, Robert G; Nicholas, Susanne B; Parekh, Rulan S; Rich, Stephen S; Chen, Yii-Der I; Saad, Mohammed F; Scavini, Marina; Schelling, Jeffrey R; Sedor, John R; Shah, Vallabh O; Taylor, Kent D; Thornley-Brown, Denyse; Zager, Philip G; Horvath, Amanda; Hanson, Robert L

    2009-11-01

    Previous studies have shown that in addition to environmental influences, type 2 diabetes mellitus (T2DM) has a strong genetic component. The goal of the current study is to identify regions of linkage for T2DM in ethnically diverse populations. Phenotypic and genotypic data were obtained from African American (AA; total number of individuals [N] = 1004), American Indian (AI; N = 883), European American (EA; N = 537), and Mexican American (MA; N = 1634) individuals from the Family Investigation of Nephropathy and Diabetes. Non-parametric linkage analysis, using an average of 4404 SNPs, was performed in relative pairs affected with T2DM in each ethnic group. In addition, family-based tests were performed to detect association with T2DM. Statistically significant evidence for linkage was observed on chromosome 4q21.1 (LOD = 3.13; genome-wide p = 0.04) in AA. In addition, a total of 11 regions showed suggestive evidence for linkage (estimated at LOD > 1.71), with the highest LOD scores on chromosomes 12q21.31 (LOD = 2.02) and 22q12.3 (LOD = 2.38) in AA, 2p11.1 (LOD = 2.23) in AI, 6p12.3 (LOD = 2.77) in EA, and 13q21.1 (LOD = . 2.24) in MA. While no region overlapped across all ethnic groups, at least five loci showing LOD > 1.71 have been identified in previously published studies. The results from this study provide evidence for the presence of genes affecting T2DM on chromosomes 4q, 12q, and 22q in AA; 6p in EA; 2p in AI; and 13q in MA. The strong evidence for linkage on chromosome 4q in AA provides important information given the paucity of diabetes genetic studies in this population.

  1. Vildagliptin vs liraglutide as a second-line therapy switched from sitagliptin-based regimens in patients with type 2 diabetes: A randomized, parallel-group study

    Science.gov (United States)

    Takeshita, Yumie; Takamura, Toshinari; Kita, Yuki; Otoda, Toshiki; Kato, Ken-ichiro; Wakakuri, Hitomi; Yamada, Masayuki; Misu, Hirofumi; Matsushima, Yukiko; Kaneko, Shuichi

    2015-01-01

    Introduction A step-up strategy for dipeptidyl peptidase (DPP)-4 inhibitor-based regimens has not yet been established. In addition, similarities and differences between DPP-4 inhibitors and glucagon-like peptide (GLP)-1 receptor agonists remain to be elucidated in humans. We investigated the pleiotropic effects of vildagliptin vs liraglutide in patients with type 2 diabetes on sitagliptin-based regimens in an open-label, randomized, clinical trial. Materials and Methods A total of 122 patients with type 2 diabetes that was inadequately controlled by sitagliptin-based regimens were randomly assigned to either vildagliptin (50 mg, twice daily) or liraglutide treatment (0.9 mg, once daily) for 12 weeks. The primary outcomes were glycated hemoglobin and body mass index. Results Both vildagliptin and liraglutide significantly lowered glycated hemoglobin within 12 weeks after switching from sitagliptin, but liraglutide produced a greater reduction (−0.67 ± 0.12% vs −0.36 ± 0.53%). Liraglutide lowered body mass index, whereas vildagliptin did not affect body mass index. Vildagliptin lowered fasting C-peptide immunoreactivity, but liraglutide did not. Vildagliptin increased serum levels of adiponectin, arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid, whereas liraglutide had no effect on these levels. Quality of life, assessed using the diabetes treatment satisfaction questionnaire, was not impaired in either group. The most common adverse events were gastrointestinal symptoms, which occurred with similar frequencies in both groups. Conclusions Vildagliptin-mediated improvements in glycemic control did not correlate with indices for insulin secretion and insulin sensitivity. Switching from sitagliptin to liraglutide is useful in managing hyperglycemia and weight. Each agent exerts unique pleiotropic effects. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (no. 000004953). PMID

  2. [Glycaemic management in type 1 and 2 diabetes patients undergoing interventional cardiology procedures. Heart and Diabetes Working Group. Sociedad Espan˜ola de Cardiologı´a. Sociedad Espan˜ola de Diabetes].

    Science.gov (United States)

    Alonso-García, Angeles; Moreno Gómez, Raúl; Miranda Guardiola, Faustino; Artola-Menéndez, Sara; Lisbona-Gil, Arturo

    2012-03-03

    Despite the growing number of therapeutic alternatives available as well as general reviews and treatment guidelines for the treatment of diabetes, physicians are often left without a clear pathway of therapy to follow in specific clinical contexts such as interventional cardiology. The present document proposes a consensus treatment algorithm, based both on a critical appraisal of evidence from recent clinical trials and on value judgements supported by the authors' collective clinical knowledge and experience, in an attempt to guide practitioners when choosing the most appropriate alternatives in the context of glycemic management in type 1 and 2 diabetic patients scheduled to undergo interventional cardiology procedures in a haemodynamic laboratory. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  3. Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2

    Directory of Open Access Journals (Sweden)

    Weijs Peter JM

    2008-12-01

    Full Text Available Abstract Background In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated. Methods Go4it is a multidisciplinary group treatment that focuses on: 1 increasing awareness of the current dietary and physical activity behaviour (i.e. energy balance behaviour, 2 improving diet, 3 decreasing sedentary behaviour, 4 increasing levels of physical activity, and 5 coping with difficult situations. Go4it consists of 7 sessions with an interval of 2–3 weeks. The effectiveness of the multidisciplinary group treatment compared with usual care (i.e. referral to a dietician was evaluated in a randomised controlled trial. We examined effects on BMI(sds, body composition, energy expenditure, glucose tolerance and insulin resistance (primary outcome measure, as well as dietary and physical activity behaviour and quality of life. An economic evaluation from a societal perspective was conducted alongside the randomised trial to evaluate the cost-effectiveness of the multidisciplinary treatment program vs. usual care. Discussion In this paper we described a multidisciplinary treatment program (Go4it for obese adolescents and the design of a randomised controlled trial and economic evaluation to evaluate its effectiveness and cost-effectiveness. Trial registration Netherlands Trial Register (ISRCTN27626398.

  4. Group clinics for young adults with diabetes in an ethnically diverse, socioeconomically deprived setting (TOGETHER study): protocol for a realist review, co-design and mixed methods, participatory evaluation of a new care model.

    Science.gov (United States)

    Papoutsi, Chrysanthi; Hargreaves, Dougal; Colligan, Grainne; Hagell, Ann; Patel, Anita; Campbell-Richards, Desirée; Viner, Russell M; Vijayaraghavan, Shanti; Marshall, Martin; Greenhalgh, Trisha; Finer, Sarah

    2017-06-21

    Young adults with diabetes often report dissatisfaction with care and have poor diabetes-related health outcomes. As diabetes prevalence continues to rise, group-based care could provide a sustainable alternative to traditional one-to-one consultations, by engaging young people through life stage-, context- and culturally-sensitive approaches. In this study, we will co-design and evaluate a group-based care model for young adults with diabetes and complex health and social needs in socioeconomically deprived areas. This participatory study will include three phases. In phase 1, we will carry out a realist review to synthesise the literature on group-based care for young adults with diabetes. This theory-driven understanding will provide the basis for phase 2, where we will draw on experience-based co-design methodologies to develop a new, group-based care model for young adults (aged quantitative methods (eg, biological markers, patient enablement instrument and diabetes distress scale), including a cost analysis. National Health Service ethics approval has been granted (reference 17/NI/0019). The project will directly inform service redesign to better meet the needs of young adults with diabetes in socioeconomically deprived areas and may guide a possible cluster-randomised trial, powered to clinical and cost-effectiveness outcomes. Findings from this study may be transferable to other long-term conditions and/or age groups. Project outputs will include briefing statements, summaries and academic papers, tailored for different audiences, including people living with diabetes, clinicians, policy makers and strategic decision makers. PROSPERO (CRD42017058726). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Pilot randomized controlled trial of a mindfulness-based group intervention in adolescent girls at risk for type 2 diabetes with depressive symptoms.

    Science.gov (United States)

    Shomaker, Lauren B; Bruggink, Stephanie; Pivarunas, Bernadette; Skoranski, Amanda; Foss, Jillian; Chaffin, Ella; Dalager, Stephanie; Annameier, Shelly; Quaglia, Jordan; Brown, Kirk Warren; Broderick, Patricia; Bell, Christopher

    2017-06-01

    (1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Parallel-group, randomized controlled pilot trial conducted at a university. Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (psmindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (psmindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. ClinicalTrials.gov identifier: NCT02218138

  6. Effects of oxidative stress on hyperglycaemia-induced brain malformations in a diabetes mouse model

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Ya [Department of Pediatrics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China (China); Wang, Guang [Division of Histology & Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou 510632 (China); Han, Sha-Sha; He, Mei-Yao [Department of Pediatrics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China (China); Cheng, Xin; Ma, Zheng-Lai [Division of Histology & Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou 510632 (China); Wu, Xia [Department of Pediatrics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China (China); Yang, Xuesong, E-mail: yang_xuesong@126.com [Division of Histology & Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou 510632 (China); Liu, Guo-Sheng, E-mail: tlgs@jnu.edu.cn [Department of Pediatrics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China (China)

    2016-09-10

    Pregestational diabetes mellitus (PGDM) enhances the risk of fetal neurodevelopmental defects. However, the mechanism of hyperglycaemia-induced neurodevelopmental defects is not fully understood. In this study, several typical neurodevelopmental defects were identified in the streptozotocin-induced diabetes mouse model. The neuron-specific class III beta-tubulin/forkhead box P1-labelled neuronal differentiation was suppressed and glial fibrillary acidic protein-labelled glial cell lineage differentiation was slightly promoted in pregestational diabetes mellitus (PGDM) mice. Various concentrations of glucose did not change the U87 cell viability, but glial cell line-derived neurotrophic factor expression was altered with varying glucose concentrations. Mouse maternal hyperglycaemia significantly increased Tunel{sup +} apoptosis but did not dramatically affect PCNA{sup +} cell proliferation in the process. To determine the cause of increased apoptosis, we determined the SOD activity, the expression of Nrf2 as well as its downstream anti-oxidative factors NQO1 and HO1, and found that all of them significantly increased in PGDM fetal brains compared with controls. However, Nrf2 expression in U87 cells was not significantly changed by different glucose concentrations. In mouse telencephalon, we observed the co-localization of Tuj-1 and Nrf2 expression in neurons, and down-regulating of Nrf2 in SH-SY5Y cells altered the viability of SH-SY5Y cells exposed to high glucose concentrations. Taken together, the data suggest that Nrf2-modulated antioxidant stress plays a crucial role in maternal hyperglycaemia-induced neurodevelopmental defects. - Highlights: • Typical neurodevelopmental defects could be observed in STZ-treated mouse fetuses. • Nrf2 played a crucial role in hyperglycaemia-induced brain malformations. • The effects of hyperglycaemia on neurons and glia cells were not same.

  7. Congestive heart failure predicts the development of non-insulin-dependent diabetes mellitus in the elderly. The Osservatorio Geriatrico Regione Campania Group.

    Science.gov (United States)

    Amato, L; Paolisso, G; Cacciatore, F; Ferrara, N; Ferrara, P; Canonico, S; Varricchio, M; Rengo, F

    1997-06-01

    Congestive heart failure (CHF) is an insulin-resistant state which constitutes the main risk factor for the development of non-insulin-dependent diabetes mellitus (NIDDM). Our study investigated the predictive role of CHF on the development of NIDDM in 1,339 elderly subjects with a mean ( +/- SD) age of 74.2 +/- 6.4 years. CHF had a 9.5% prevalence, and 14.7% of the subjects had NIDDM. After stratification by age, subjects between 80 and 84 years had the highest prevalence of CHF and a total of 29.6% of CHF patients had NIDDM. In multiple logistic regression analysis, CHF was associated with NIDDM [odds ration (OR) = 2.0, 95% confidence interval (CI) - 1.6-2.5] independent of age, sex, family history of diabetes, body mass index, (BMI), waist/hip ratio, and diastolic blood pressure. When only untreated CHF patients were taken into account, the association between CHF and NIDDM was even stronger (OR = 4.0, 95% CI = 3.4-5.8). When untreated CHF patients were grouped into those with low (I and II) and high (III and IV) New York Heart Association (NYHA) classes, the association of CHF and NIDDM was stronger with the worsening of CHF. In a longitudinal study, CHF predicted NIDDM independently of age, sex, family history of diabetes, BMI, waist/hip ratio, systolic and diastolic blood pressure, and therapy for CHF (OR = 1.4, 95% CI = 1.1-1.8). CHF was associated with a higher prevalence of NIDDM and was a risk factor for its development. Elevated FFA concentrations may play a pivotal role.

  8. Type 2 Diabetes among 6 Asian Ethnic Groups in California: The Nexus of Ethnicity, Gender, and Generational Status.

    Science.gov (United States)

    Huang, Z Jennifer; Zheng, Chaoyi

    2015-05-01

    We examined associations between generational status and age-adjusted type 2 diabetes (T2DM) among Asians living in California. We abstracted data on 7,188 Asian Americans of six ethnicities from the 2007 and 2009 California Health Interview Survey. Age-and ethnicity-specific logistic regression analyses were used to model prevalence of T2DM based on 29 generational status and language spoken at home. Second-generation Asian men and first-generation Asian women had higher T2DM prevalence compared with their White peers. Such a trend was observed among Chinese and Filipino men, and Filipina and Korean women. In addition, Filipinas who spoke only English at home had lower odds of T2DM than other Filipinas (OR=0.3, 95% CI: 0.1-1.0) while the relationship was reversed among Filipino men (OR=3.2, 95% CI 1.0-10.1). Associations between generational status and T2DM among Asian Americans are non-linear and strongly influenced by gender and ethnicity.

  9. Process evaluation of a patient-centred, patient-directed, group-based education program for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Odgers-Jewell, Kate; Isenring, Elisabeth; Thomas, Rae; Reidlinger, Dianne P

    2017-07-01

    The present study developed and evaluated a patient-centred, patient-directed, group-based education program for the management of type 2 diabetes mellitus. Two frameworks, the Medical Research Council (MRC) framework for developing and evaluating complex interventions and the RE-AIM framework were followed. Data to develop the intervention were sourced from scoping of the literature and formative evaluation. Program evaluation comprised analysis of primary recruitment of participants through general practitioners, baseline and end-point measures of anthropometry, four validated questionnaires, contemporaneous facilitator notes and telephone interviews with participants. A total of 16 participants enrolled in the intervention. Post-intervention results were obtained from 13 participants, with an estimated mean change from baseline in weight of -0.72 kg (95%CI -1.44 to -0.01), body mass index of -0.25 kg/m 2 (95%CI -0.49 to -0.01) and waist circumference of -1.04 cm (95%CI -4.52 to 2.44). The group education program was acceptable to participants. The results suggest that recruitment through general practitioners is ineffective, and alternative recruitment strategies are required. This patient-centred, patient-directed, group-based intervention for the management of type 2 diabetes mellitus was both feasible and acceptable to patients. Health professionals should consider the combined use of the MRC and RE-AIM frameworks in the development of interventions to ensure a rigorous design process and to enable the evaluation of all phases of the intervention, which will facilitate translation to other settings. Further research with a larger sample trialling additional recruitment strategies, evaluating further measures of effectiveness and utilising lengthier follow-up periods is required. © 2016 Dietitians Association of Australia.

  10. [Evaluation of an intensive treatment education program for type 1 diabetes in a group of adolescents. A two year follow up].

    Science.gov (United States)

    Krochik, Andrea G; Mazza, Carmen S; Araujo, Maria B; Kovalskys, Irina; Ozuna, Blanca; Assad, Daniel; Coppola, Liliana; Domenech, Irene; Lahera, Elba; Zufriategui, Zulma; Gagliardino, Juan J

    2004-01-01

    During the past decade several reports were published showing that intensive treatment of type 1 diabetes can prevent and delay disease-related microvascular complications. However, several problems were reported in children and adolescents such as frequent hypoglycemic episodes and weight gain. The aim of this study was to describe the results of intensified treatment for type 1 diabetes in a group of Argentinean adolescents after a follow-up of two years. Twenty five adolescents with type 1 diabetes older than 10 years with at least one year from diagnosis were selected. All patients received a one-week teaching program during admission to our center. All patients were followed-up monthly during two years. Treatment schedule included 4-5 controls in fasting conditions, two doses of NPH insulin and four doses of regular insulin according to glycemia and the amount of calculated carbohydrate intake. Median age was 13.5 years (range 10 to 19 years). Mean time from diagnosis to inclusion in the study was 3.8 years (range 1.25 to 9 years). Mean total dose of NPH insulin decreased significantly when measured at the inclusion in the study (0.9 IU/kg) and after a year of follow-up 0.8 IU/kg (p 0.04). However, there were no changes in NPH insulin dose after two years follow-up (0.85 IU/kg). On the contrary, the dose of regular insulin administered on fasting conditions with normal glycemia increased from 0 to 0.21/kg after a year (p 0.0001) and to 0.69 after two years (non significant). Median HbA1C showed a significant reduction from 10 +/- 1.62% to 8.53 +/- 1.04% after a year (p 0.03) and to 8.72 +/- 0.81% after two years. BMI Z score increased from significantly from 0.7 +/- 0.9 to 1.06 +/- 1.15 after a year (p 0.03) with a further reduction without a significant difference from the basal value after two years. We found no significant differences in the frequency of hypoglycemia or other metabolic features. Our results show that intensive treatment of type 1 diabetes

  11. Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients

    National Research Council Canada - National Science Library

    Ashur, S T; Shamsuddin, K; Shah, S A; Bosseri, S; Morisky, D E

    2015-01-01

    ...(©)) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya...

  12. Application of group-based QSAR on 2-thioxo-4-thiazolidinone for development of potent anti-diabetic compounds

    Science.gov (United States)

    Choudhari, Prafulla; Kumbhar, Santosh; Phalle, Siddharth; Choudhari, Sujata; Desai, Sujit; Khare, Shivratna; Jadhav, Swapnil

    2017-01-01

    To identify the structural requirement for development of lead structures with PPAR gamma binding activity group based quantitative structure activity relationship (GQSAR) studies on 46 reported structures were carried out. The molecules in the current dataset were fragmented into seven functional groups fragments (R1, R2, R3, R4, R5, R6 and R7). GQSAR models were derived using multiple linear regressions analysis. Four generated GQSAR models were selected based on the statistical significance of the model. It was found that the presence of smaller groups on fragment R7 and presence of lipophilic group at fragment R2 was conducive for PPAR gamma binding. Additionally, the existence of hydrogen bond acceptor at fragments R6 was fruitful PPAR gamma binding. The generated models provide a site-specific insight into the structural requirements PPAR γ binding which can be used to design and develop potent antidiabetic compounds.

  13. Frequency of diabetes, impaired fasting glucose, and glucose intolerance in high-risk groups identified by a FINDRISC survey in Puebla City, Mexico

    OpenAIRE

    Hirales-Tamez O; Genestier-Tamborero CN; García-Alcalá H; Salinas-Palma J; Soto-Vega E

    2012-01-01

    Hector García-Alcalá, Christelle Nathalie Genestier-Tamborero, Omara Hirales-Tamez, Jorge Salinas-Palma, Elena Soto-VegaFaculty of Medicine, Universidad Popular Autónoma del Estado de Puebla, Puebla Pue, MexicoBackground: As a first step in the prevention of diabetes, the International Diabetes Federation recommends identification of persons at risk using the Finnish type 2 Diabetes Risk Assessment (FINDRISC) survey. The frequency of diabetes mellitus, impaire...

  14. Diabetes Prevention and Management among Minority Ethnic Groups in Nicaragua: Findings from Phase 2 of a Community-Based Participatory Research Study

    Science.gov (United States)

    Newlin Lew, Kelley; Mitchell, Emma McKim; Mclean, Yolanda

    2016-01-01

    Objectives: To (1) describe barriers to diabetes prevention and self-management, (2) explore how religious beliefs inform diabetes prevention and self-management and (3) describe community action strategies to address the problem of diabetes locally. Design: Qualitative, descriptive design. Setting: Three Moravian Churches located, respectively,…

  15. Diabetic Coma

    Science.gov (United States)

    ... Overview A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously ... Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed March 31, 2015. Hyperglycemia ( ...

  16. The thermic response to food is related to sensitivity to adrenaline in a group at risk for the development of type II diabetes.

    Science.gov (United States)

    Forbes, S; Robinson, S; Parker, K H; Macdonald, I A; McCarthy, M I; Johnston, D G

    2009-11-01

    To analyze whether a decreased sensitivity to adrenaline in women with earlier gestational diabetes (GDM) explains the impairment in the thermogenic response to food (=post-prandial thermogenesis (PPT)) that is observed in these women at future risk of obesity and type II diabetes. Ten normal-weight women with previous GDM and 10 controls matched for body weight, all with normal glucose tolerance, had insulin sensitivity, PPT and the thermogenic response to an adrenaline infusion measured. Insulin sensitivity was similar in the previous GDM compared with control groups: (mean+/-s.e.m.) 29.1+/-3.2 vs 30.9+/-1.6 mg/l/min. The early (0-30 min) PPT response was diminished and delayed in women with previous GDM compared with controls: (10+/-2 vs 15+/-1 kJ, P=0.04); time constant for PPT (median (interquartile range)) (57 (47-79) vs 29 (25-49) min, P=0.01). The overall PPT response and the thermogenic response to adrenaline were not significantly different between the groups. The 30 min and 2 h PPT response correlated positively and significantly with the increment in energy expenditure as a result of the adrenaline infusion (rho=+0.65; P=0.04 and rho=+0.71; P=0.02, respectively) in women with previous GDM only. There was no correlation between adrenaline and insulin sensitivity. There is no evidence of diminished adrenaline sensitivity but a positive relationship exists between PPT and sensitivity to adrenaline in women with previous GDM. The mechanism is not mediated through insulin resistance. This relationship may predispose these normal-weight at-risk women to future weight gain.

  17. Cohort profiles of the cross-sectional and prospective participant groups in the second Diabetes MILES-Australia (MILES-2) study

    DEFF Research Database (Denmark)

    Browne, Jessica L; Holmes-Truscott, Elizabeth; Ventura, Adriana D

    2017-01-01

    and social aspects of diabetes. The aim of the MILES-2 study was to provide a (1) longitudinal follow-up of the original MILES 2011 study cohort; (2) cross-sectional assessment of a new cohort. PARTICIPANTS: Eligible participants were English-speaking Australians with type 1 or type 2 diabetes, aged 18....... The final sample included N=2342 eligible respondents (longitudinal cohort: n=504; 2015 new cohort: n=1838); 54% had type 2 diabetes. FINDINGS TO DATE: Survey respondents were from an advantaged socioeconomic background compared to the general population. Respondents with type 1 diabetes were over......-represented in the new cohort (45%) relative to the planned stratification (40% type 1 diabetes, 60% type 2 diabetes). Respondents with insulin-treated type 2 diabetes were under-represented in the new cohort relative to the stratified sampling (42% invited vs 50% response). Participants who completed both the 2011...

  18. Age-specific impact of diabetes mellitus on the risk of cardiovascular mortality: An overview from the evidence for Cardiovascular Prevention from Observational Cohorts in the Japan Research Group (EPOCH-JAPAN).

    Science.gov (United States)

    Hirakawa, Yoichiro; Ninomiya, Toshiharu; Kiyohara, Yutaka; Murakami, Yoshitaka; Saitoh, Shigeyuki; Nakagawa, Hideaki; Okayama, Akira; Tamakoshi, Akiko; Sakata, Kiyomi; Miura, Katsuyuki; Ueshima, Hirotsugu; Okamura, Tomonori

    2017-03-01

    Diabetes mellitus is a strong risk factor for cardiovascular disease. However, the age-specific association of diabetes with cardiovascular risk, especially in the elderly, remains unclear in non-Western populations. A pooled analysis was conducted using 8 cohort studies (mean follow-up period, 10.3 years) in Japan, combining the data from 38,854 individual participants without history of cardiovascular disease. In all, 1867 of the participants had diabetes, defined based on the 1998 World Health Organization criteria. The association between diabetes and the risk of death from cardiovascular disease, coronary heart disease (CHD), and stroke was estimated using a stratified Cox model, accounting for variability of baseline hazard functions among cohorts. During the follow-up, 1376 subjects died of cardiovascular disease (including 268 of coronary heart disease and 621 of stroke). Diabetes was associated with an increased risk of cardiovascular death after multivariable adjustment (hazard ratio [HR] 1.62; 95% confidence interval [CI], 1.35-1.94). Similarly, diabetes was a risk factor for CHD (HR 2.13; 95% CI, 1.47-3.09) and stroke (HR 1.40; 95% CI, 1.05-1.85). In the age-stratified analysis of the risk of cardiovascular death, the relative effects of diabetes were consistent across age groups (p for heterogeneity = 0.18), whereas the excess absolute risks of diabetes were greater in participants in their 70s and 80s than in younger subjects. The management of diabetes is important to reduce the risk of death from cardiovascular disease, not only in midlife but also in late life, in the Japanese population. Copyright © 2016. Production and hosting by Elsevier B.V.

  19. Pneumococcal polysaccharide vaccination elicits IgG anti-AB blood group antibodies in healthy individuals and patients with Type I diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Wendelin Wolfram

    2016-11-01

    Full Text Available Hypothesis: Blood group antibodies are natural antibodies that develop early in life in response to cross-reactive environmental antigens in the absence of antigen encounter. Even later in life structural similarities in saccharide composition between environmental antigens such as bacterial polysaccharides and blood group A/B antigens could lead to changes in serum levels, IgM/IgG isotype and affinity maturation of blood group anti-A/B antibodies. We adressed the question whether immunization with pneumococcal polysaccharide (PnP vaccine (PPV Pneumovax®23 could have such an effect in patients with with type I diabetes mellitus (DM I, an autoimmune disease where an aberrant immune response to microbial antigens likely plays a role.Methods: Anti-PnP IgM and IgG responses were determined by ELISA and the Diamed-ID Micro Typing System was used to screen anti-A/B antibody titer before and after Pneumovax®23 immunization in 28 healthy individuals and 16 patients with DM I. In addition, surface plasmon resonance (SPR technology using the Biacore® device and a synthetic blood group A/B trisaccharide as the antigen was applied to investigate IgM and IgG anti-A/B antibodies and to measure antibody binding dynamics. Results: All healthy individuals and DM I patients responded with anti-PnP IgM and IgG antibody production four to six weeks after Pneumovax®23 (Pn23 immunization, while no increase in blood group anti-A/B antibody titer was observed when measured by the Diamed-ID Micro Typing System. Interestingly, isotype-specific testing by SPR-technology revealed an increase in blood group anti-A/B IgG, but not IgM, following Pn23 immunization in both patients and controls. No change in binding characteristics of blood group anti-A/B antibodies could be detected following Pn23 vaccination, supporting the assumption of an increase in IgG antibody titer with no or very little affinity maturation.Conclusion: The study provides evidence for epitope sharing

  20. Pneumococcal Polysaccharide Vaccination Elicits IgG Anti-A/B Blood Group Antibodies in Healthy Individuals and Patients with Type I Diabetes Mellitus.

    Science.gov (United States)

    Wolfram, Wendelin; Sauerwein, Kai M T; Binder, Christoph J; Eibl-Musil, Nicole; Wolf, Hermann M; Fischer, Michael B

    2016-01-01

    Blood group antibodies are natural antibodies that develop early in life in response to cross-reactive environmental antigens in the absence of antigen encounter. Even later in life structural similarities in saccharide composition between environmental antigens such as bacterial polysaccharides and blood group A/B antigens could lead to changes in serum levels, IgM/IgG isotype, and affinity maturation of blood group anti-A/B antibodies. We addressed the question whether immunization with pneumococcal polysaccharide (PnP) vaccine Pneumo 23 Vaccine "Pasteur Merieux" (Pn23) could have such an effect in patients with type I diabetes mellitus (DM I), an autoimmune disease where an aberrant immune response to microbial antigens likely plays a role. Anti-PnP IgM and IgG responses were determined by ELISA, and the DiaMed-ID Micro Typing System was used to screen anti-A/B antibody titer before and after Pn23 immunization in 28 healthy individuals and 16 patients with DM I. In addition, surface plasmon resonance (SPR) technology using the Biacore(®) device and a synthetic blood group A/B trisaccharide as the antigen was applied to investigate IgM and IgG anti-A/B antibodies and to measure antibody binding dynamics. All healthy individuals and DM I patients responded with anti-PnP IgM and IgG antibody production 4-6 weeks after Pn23 immunization, while no increase in blood group anti-A/B antibody titer was observed when measured by the DiaMed-ID Micro Typing System. Interestingly, isotype-specific testing by SPR technology revealed an increase in blood group anti-A/B IgG, but not IgM, following Pn23 immunization in both patients and controls. No change in binding characteristics of blood group anti-A/B antibodies could be detected following Pn23 vaccination, supporting the assumption of an increase in IgG antibody titer with no or very little affinity maturation. The study provides evidence for epitope sharing between pneumococcal polysaccharides and blood group ABO

  1. The Association between Food Group Consumption Patterns and Early Metabolic Syndrome Risk in Non-Diabetic Healthy People.

    Science.gov (United States)

    Yeo, Rimkyo; Yoon, So Ra; Kim, Oh Yoen

    2017-07-01

    We investigated the association between dietary habits/food group consumption patterns and early risk of metabolic syndrome (MetS), a main cause for metabolic disease. Study participants were recruited from the health promotion center in Dong-A University Hospital and public advertisement. Study subjects (n = 243, 21-80 years) were categorized into three groups: Super-healthy (MetS risk factor [MetS RF] = 0, n = 111), MetS-risk carriers (MetS RF = 1-2, n = 96), and MetS (MetS RF ≥ 3, n = 27). Higher regularity in dietary habits (breakfast-everyday, regular eating time, non-frequent overeating, and non-frequent eating-out) was observed in the Super-healthy group than in the MetS-risk carriers, and particularly in the MetS subjects. The relationship between food group consumption patterns and MetS-risk related parameters were investigated with adjustment for confounding factors. Fruit consumption was positively associated with HDL-cholesterol, and tended to be negatively associated with waist circumference, triglyceride, LDL-cholesterol, and insulin resistance (IR). The consumption of low-fat meats and fish, and vegetables was negatively associated with hs-CRP. Specifically, the consumption of sea-foods belonging to the low-fat fish was negatively associated with fasting glucose, hs-CRP, and interleukin (IL)-6. Anchovy/dried white baits consumption was negatively associated with fasting insulin and IR. Green-yellow vegetables consumption was negatively associated with fasting insulin, IR, and hs-CRP. On the other hand, sugars and fast-foods were positively associated with LDL-cholesterol. Additionally, fast-foods consumption was positively associated with hs-CRP and IL-6 levels. In conclusion, dietary habits/food group consumption patterns are closely associated with MetS-risk related parameters in Koreans. It may suggest useful information to educate people to properly select healthy foods for early prevention of MetS.

  2. Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil: data from the Brazilian Type 1 Diabetes Study Group.

    Science.gov (United States)

    Felício, João Soares; de Souza, Ana Carolina Contente Braga; Koury, Camila Cavalcante; Neto, João Felício Abrahão; Miléo, Karem Barbosa; Santos, Flávia Marques; Motta, Ana Regina Bastos; Silva, Denisson Dias; Arbage, Thaís Pontes; Carvalho, Carolina Tavares; de Rider Brito, Hana Andrade; Yamada, Elizabeth Sumi; Cobas, Roberta Arnoldi; Matheus, Alessandra; Tannus, Lucianne; Palma, Catia Cristina Sousa; Japiassu, Leticia; Carneiro, João Regis Ivar; Rodacki, Melanie; Zajdenverg, Lenita; de Araújo, Neuza Braga Campos; de Menezes Cordeiro, Marilena; Luescher, Jorge Luiz; Berardo, Renata Szundy; Nery, Marcia; Cani, Catarina; do Carmo Arruda Marques, Maria; Calliari, Luiz Eduardo; de Noronha, Renata Maria; Manna, Thais Della; Savoldelli, Roberta; Penha, Fernanda Garcia; Foss, Milton Cesar; Foss-Freitas, Maria Cristina; Pires, Antonio Carlos; Robles, Fernando Cesar; Negrato, Carlos Antonio; de Fatima Guedes, Maria; Dib, Sergio Atala; Dualib, Patricia; da Silva, Saulo Cavalcanti; Sepúlveda, Janice; Sampaio, Emerson; Rea, Rosangela Roginski; de Almeida Faria, Ana Cristina Ravazzani; Tschiedel, Balduino; Lavigne, Suzana; Cardozo, Gustavo Adolfo; Azevedo, Mirela; Canani, Luis Henrique; Zucatti, Alessandra Teixeira; Coral, Marisa Helena Cesar; Pereira, Daniela Aline; de Araujo, Luiz Antonio; Pedrosa, Hermelinda Cordeiro; Tolentino, Monica; Prado, Flaviene Alves; Rassi, Nelson; de Araujo, Leticia Bretones; Fonseca, Reine Marie Chaves; Guedes, Alexis Dourado; de Mattos, Odelisa Silva; Faria, Manuel; Azulay, Rossana; E Forti, Adriana Costa; Façanha, Cristina Figueiredo Sampaio; Junior, Renan Montenegro; Montenegro, Ana Paula; Melo, Naira Horta; Rezende, Karla Freire; Ramos, Alberto; Jezini, Deborah Laredo; Gomes, Marilia Brito

    2015-01-01

    In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities.

  3. Hearing and diabetes.

    Science.gov (United States)

    de España, R; Biurrun, O; Lorente, J; Traserra, J

    1995-01-01

    The results of the audiological evaluation of 47 diabetics are presented. The patients were divided into two groups: A (17/47), type I early diabetics, and B (30/47), type I chronic diabetics. The evaluation included puretone audiometry, high-frequency audiometry and auditory brainstem response. There was a control group consisting of 30 healthy subjects. In group 1 the audiological assessment was normal in all cases. In group 2 hearing loss was found in 30% of cases (9/30). Hearing loss was significantly correlated with age (p = 0.0019) and duration of diabetes (p = 0.0143), but not with diabetic microangiopathy (p = 0.1506). The authors conclude that hearing loss is not a usual feature in diabetic patients. When present, hearing loss should be attributed to the effect of diabetes on the age-related physiological impairment of the inner ear. The pathogenic mechanisms remain obscure.

  4. The effect of community groups and mobile phone messages on the prevention and control of diabetes in rural Bangladesh: study protocol for a three-arm cluster randomised controlled trial.

    Science.gov (United States)

    Fottrell, Edward; Jennings, Hannah; Kuddus, Abdul; Ahmed, Naveed; Morrison, Joanna; Akter, Kohenour; Shaha, Sanjit Kumar; Nahar, Badrun; Nahar, Tasmin; Haghparast-Bidgoli, Hassan; Khan, A K Azad; Costello, Anthony; Azad, Kishwar

    2016-12-19

    Increasing rates of type 2 diabetes mellitus place a substantial burden on health care services, communities, families and individuals living with the disease or at risk of developing it. Estimates of the combined prevalence of intermediate hyperglycaemia and diabetes in Bangladesh vary, and can be as high as 30% of the adult population. Despite such high prevalence, awareness and control of diabetes and its risk factors are limited. Prevention and control of diabetes and its complications demand increased awareness and action of individuals and communities, with positive influences on behaviours and lifestyle choices. In this study, we will test the effect of two different interventions on diabetes occurrence and its risk factors in rural Bangladesh. A three-arm cluster randomised controlled trial of mobile health (mHealth) and participatory community group interventions will be conducted in four rural upazillas in Faridpur District, Bangladesh. Ninety-six clusters (villages) will be randomised to receive either the mHealth intervention or the participatory community group intervention, or be assigned to the control arm. In the mHealth arm, enrolled individuals will receive twice-weekly voice messages sent to their mobile phone about prevention and control of diabetes. In the participatory community group arm, facilitators will initiate a series of monthly group meetings for men and women, progressing through a Participatory Learning and Action cycle whereby group members and communities identify, prioritise and tackle problems associated with diabetes and the risk of developing diabetes. Both interventions will run for 18 months. The primary outcomes of the combined prevalence of intermediate hyperglycaemia and diabetes and the cumulative 2-year incidence of diabetes among individuals identified as having intermediate hyperglycaemia at baseline will be evaluated through baseline and endline sample surveys of permanent residents aged 30 years or older in each of

  5. Avaliação estratégica de educação em grupo e individual no programa educativo em diabetes Evaluación estratégica de educación en grupo e individual en el programa educativo en diabetes Evaluation of group and individual strategies in a diabetes education program

    Directory of Open Access Journals (Sweden)

    Heloisa de Carvalho Torres

    2009-04-01

    ñado individualmente. El acompañamiento ocurrió por seis meses durante el año de 2006, siendo evaluados por cuestionarios específicos: conocimientos en diabetes, actitudes psicológicas, cambio de comportamiento, calidad de vida. Fue realizada evaluación clínica en el tiempo inicial, después de tres y seis meses de intervención. RESULTADOS: El promedio de edad de los pacientes era de 60,6 años. Los resultados de la educación en grupo e individual fueron semejantes en la prueba de actitudes, cambio de comportamiento y calidad de vida. Se observó reducción en los niveles de HbA1c en los dos grupos, mientras que en el de educación en grupo la diferencia presentó significancia estadística (p=0,012. CONCLUSIONES: Las dos estrategias del programa educativo en diabetes fueron efectivas, sin embargo, la educación en grupo presentó mejores resultados de control glicérico en comparación con la individual.OBJECTIVE: To compare the effectiveness of individual and group strategies in a diabetes education program. METHODS: A total of 104 type-2 diabetes outpatients enrolled in an education program of a teaching hospital in Belo Horizonte, Southeastern Brazil, were randomly selected and assigned to two different education strategies: group education (54 subjects and individual education (50 subjects. Group education comprised three monthly sessions, which involved play and interactive dynamics. In parallel, a second group received individual education. Subjects were follow up for six months during 2006 and they were evaluated using specific questionnaires: knowledge of diabetes, psychological attitudes, change in behavior, quality of life. Clinical evaluation was performed at baseline, three and six months of intervention. RESULTS: Mean age was 60.6 years. The results of group and individual education were similar in the assessment tests of attitude, change of behavior and quality of life. A reduction in HbA1c levels was seen in both groups, but a statistically significant

  6. CaV3.2 T-type calcium channels in peripheral sensory neurons are important for mibefradil-induced reversal of hyperalgesia and allodynia in rats with painful diabetic neuropathy.

    Science.gov (United States)

    Obradovic, Aleksandar Lj; Hwang, Sung Mi; Scarpa, Joseph; Hong, Sung Jun; Todorovic, Slobodan M; Jevtovic-Todorovic, Vesna

    2014-01-01

    We recently showed that streptozotocin (STZ) injections in rats lead to the development of painful peripheral diabetic neuropathy (PDN) accompanied by enhancement of CaV3.2 T-type calcium currents (T-currents) and hyperexcitability in dorsal root ganglion (DRG) neurons. Here we used the classical peripherally acting T-channel blocker mibefradil to examine the role of CaV3.2 T-channels as pharmacological targets for treatment of painful PDN. When administered intraperitoneally (i.p.), at clinically relevant doses, mibefradil effectively alleviated heat, cold and mechanical hypersensitivities in STZ-treated diabetic rats in a dose-dependent manner. We also found that CaV3.2 antisense (AS)-treated diabetic rats exhibit a significant decrease in painful PDN compared with mismatch antisense (MIS)-treated diabetic rats. Co-treatment with mibefradil (9 mg/kg i.p.) resulted in reversal of heat, cold and mechanical hypersensitivity in MIS-treated but not in AS-treated diabetic rats, suggesting that mibefradil and CaV3.2 AS share the same cellular target. Using patch-clamp recordings from acutely dissociated DRG neurons, we demonstrated that mibefradil similarly blocked T-currents in diabetic and healthy rats in a voltage-dependent manner by stabilizing inactive states of T-channels. We conclude that antihyperalgesic and antiallodynic effects of mibefradil in PDN are at least partly mediated by inhibition of CaV3.2 channels in peripheral nociceptors. Hence, peripherally acting voltage-dependent T-channel blockers could be very useful in the treatment of painful symptoms of PDN.

  7. Efficacy and safety of pioglitazone added to alogliptin in Japanese patients with type 2 diabetes mellitus: a multicentre, randomized, double-blind, parallel-group, comparative study.

    Science.gov (United States)

    Kaku, K; Katou, M; Igeta, M; Ohira, T; Sano, H

    2015-12-01

    A phase IV, multicentre, randomized, double-blind, parallel-group, comparative study was conducted in Japanese subjects with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control, despite treatment with alogliptin in addition to diet and/or exercise therapy. Subjects with glycated haemoglobin (HbA1c) concentrations of 6.9-10.5% were randomized to receive 16 weeks' double-blind treatment with pioglitazone 15 mg, 30 mg once daily or placebo added to alogliptin 25 mg once daily. The primary endpoint was the change in HbA1c from baseline at the end of treatment period (week 16). Both pioglitazone 15 and 30 mg combination therapy resulted in a significantly greater reduction in HbA1c than alogliptin monotherapy [-0.80 and -0.90% vs 0.00% (the least squares mean using analysis of covariance model); p < 0.0001, respectively]. The overall incidence rates of treatment-emergent adverse events were similar among the treatment groups. Pioglitazone/alogliptin combination therapy was effective and generally well tolerated in Japanese subjects with T2DM and is considered to be useful in clinical settings. © 2015 John Wiley & Sons Ltd.

  8. Predictor Variables of Developing Anterior Pituitary Deficiencies in a Group of Paediatric Patients with Central Diabetes Insipidus and Langerhans Cell Histiocytosis.

    Science.gov (United States)

    Vaiani, Elisa; Malossetti, Carmen; Vega, Lina Margarita; Zubizarreta, Pedro; Braier, Jorge; Belgorosky, Alicia

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder of unknown etiopathogenesis. Central diabetes insipidus (CDI) is the most frequent endocrine manifestation and is a known risk factor for the development of further anterior pituitary hormone deficiencies (APD). However, not all CDI patients develop APD, as observed during prolonged periods of follow-up. To find predictors of developing APD in LCH children with CDI followed in our institution. We retrospectively analysed 44 patients over a median period (quartiles) of 12.3 years (8.79-14.24). Patients were subdivided into group 1 and group 2, according to absence or presence of APD, respectively. The main variables studied were: (1) chronological age (CA) at LCH diagnosis, (2) the primary site of LCH at diagnosis: low risk (LR) and multisystemic risk organs, and (3) the presence of reactivation. Multivariate Cox regression analysis showed that APD was positively associated with CA at LCH diagnosis [relative risk (RR) 1.14, p < 0.01], the LR clinical form (RR 8.6, p < 0.03), and negatively associated with the presence of reactivations (RR 0.3, p < 0.01). Patients with older CA at LCH diagnosis, LR clinical forms, and fewer reactivation episodes might represent a subgroup of paediatric LCH CDI patients with a higher risk of developing APD. © 2016 S. Karger AG, Basel.

  9. Cohort profiles of the cross-sectional and prospective participant groups in the second Diabetes MILES-Australia (MILES-2) study

    DEFF Research Database (Denmark)

    Browne, Jessica L; Holmes-Truscott, Elizabeth; Ventura, Adriana D

    2017-01-01

    and social aspects of diabetes. The aim of the MILES-2 study was to provide a (1) longitudinal follow-up of the original MILES 2011 study cohort; (2) cross-sectional assessment of a new cohort. PARTICIPANTS: Eligible participants were English-speaking Australians with type 1 or type 2 diabetes, aged 18....... The final sample included N=2342 eligible respondents (longitudinal cohort: n=504; 2015 new cohort: n=1838); 54% had type 2 diabetes. FINDINGS TO DATE: Survey respondents were from an advantaged socioeconomic background compared to the general population. Respondents with type 1 diabetes were over...

  10. Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie’s disease? Analysis in 279 patients with a control group in Sicily

    National Research Council Canada - National Science Library

    Pavone, Carlo; D’Amato, Francesco; Dispensa, Nino; Torretta, Federico; Magno, Carlo

    2015-01-01

    ...), the second one composed by patients with other andrological diseases (control arm). For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function...

  11. New 1,4-Dihydropyridines Down-regulate Nitric Oxide in Animals with Streptozotocin-induced Diabetes Mellitus and Protect Deoxyribonucleic Acid against Peroxynitrite Action.

    Science.gov (United States)

    Leonova, Elina; Sokolovska, Jelizaveta; Boucher, Jean-Luc; Isajevs, Sergejs; Rostoka, Evita; Baumane, Larisa; Sjakste, Tatjana; Sjakste, Nikolajs

    2016-07-01

    Diabetes mellitus (DM) and its complications cause numerous health and social problems throughout the world. Pathogenic actions of nitric oxide (NO) are responsible to a large extent for development of complications of DM. Search for compounds regulating NO production in patients with DM is thus important for the development of pharmacological drugs. Dihydropyridines (1,4-DHPs) are prospective compounds from this point of view. The goals of this study were to study the in vivo effects of new DHPs on NO and reactive nitrogen and oxygen species production in a streptozotocin (STZ)-induced model of DM in rats and to study their ability to protect DNA against nocive action of peroxynitrite. STZ-induced diabetes caused an increase in NO production in the liver, kidneys, blood and muscles, but a decrease in NO in adipose tissue of STZ-treated animals. Cerebrocrast treatment was followed by normalization of NO production in the liver, kidneys and blood. Two other DHPs, etaftorone and fenoftorone, were effective in decreasing NO production in kidneys, blood and muscles of diabetic animals. Furthermore, inhibitors of nitric oxide synthase (NOS) and an inhibitor of xanthine oxidoreductase (XOR) decreased NO production in kidneys of diabetic animals. Treatment with etaftorone decreased expression of inducible NOS and XOR in kidneys, whereas it increased the expression of endothelial NOS. In vitro, the studied DHPs did not significantly inhibit the activities of NOS and XOR but affected the reactivity of peroxynitrite with DNA. These new DHPs thus appear of strong interest for treatment of DM complications. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  12. Diabetes - resources

    Science.gov (United States)

    Resources - diabetes ... The following sites provide further information on diabetes: American Diabetes Association -- www.diabetes.org Juvenile Diabetes Research Foundation International -- www.jdrf.org National Center for Chronic Disease Prevention and Health Promotion -- ...

  13. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

    Directory of Open Access Journals (Sweden)

    Aquiles Salas

    Full Text Available Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria.Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L.Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116, Puerto Rico (43.4%, 197, and urban (27.0%, 125, and rural Mexico (23.7%, 111 already exceeds that in the USA, while that in Venezuela (20.9%, 100 is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%, rural India (6.6% and Nigeria (6.0%. and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes.Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

  14. Influence of socioeconomic lifestyle factors and genetic polymorphism on type 2 diabetes occurrences among Tunisian Arab and Berber groups of Djerba Island.

    Science.gov (United States)

    Ouederni, Thouraya Baroudi; Fadiel, Ahmed; Stambouli, Nejla; Scalize, Trudy J; Ben Maiz, Hedi; Abid, Hafaona Kammoun; Bouhaha, Rim; Sanchez-Corona, Jose; Hamza, Adel; Benammar-Elgaaied, Amel

    2009-01-01

    Type 2 diabetes mellitus (T2DM) is characterized by three major metabolic abnormalities: impaired insulin-stimulated glucose uptake in muscle and adipose tissues, alterations in glucose-stimulated insulin secretion, and increased hepatic glucose production. Both genetic and environmental factors contribute to its development. The insulin gene (INS), insulin receptor gene (INSR), and insulin receptor substrate 1 gene (IRS1), identified by polymerase chain reaction and digestion with selected restriction enzymes PstI, NsiI, and BstnI, have been proposed as T2DM candidate genes. To determine the contribution of genetic and environmental factors on the occurrence of T2DM, we examined the frequency of T2DM among two ethnically diverse populations, Arabs and Berbers, who have shared the same environment, the island of Djerba, for thousands of years. Both populations have a high prevalence of obesity,T2DM, and a high consanguinity rate. A total of 162 T2DM men and women were matched to 110 healthy male and female controls. Results showed that the NsiI polymorphism in INSR and BstnI polymorphism of IRS1 were significantly associated with T2DM only among the Berber group. The PstI polymorphism in INS, was not associated with T2DM in either group. Sedentary lifestyles, lower physical activity, and lower educational levels were associated with T2DM among the Berber group. These findings suggest that the insulin receptor gene and lifestyle factors in combination may contribute to the occurrence of T2DM in the Berber portion of this island population.

  15. Influence of socioeconomic lifestyle factors and genetic polymorphism on type 2 diabetes occurrences among Tunisian Arab and Berber groups of Djerba Island

    Science.gov (United States)

    Ouederni, Thouraya Baroudi; Fadiel, Ahmed; Stambouli, Nejla; Scalize, Trudy J; Ben Maiz, Hedi; Abid, Hafaona Kammoun; Bouhaha, Rim; Sanchez-Corona, Jose; Hamza, Adel; Benammar-Elgaaied, Amel

    2009-01-01

    Type 2 diabetes mellitus (T2DM) is characterized by three major metabolic abnormalities: impaired insulin-stimulated glucose uptake in muscle and adipose tissues, alterations in glucose-stimulated insulin secretion, and increased hepatic glucose production. Both genetic and environmental factors contribute to its development. The insulin gene (INS), insulin receptor gene (INSR), and insulin receptor substrate 1 gene (IRS1), identified by polymerase chain reaction and digestion with selected restriction enzymes PstI, NsiI, and BstnI, have been proposed as T2DM candidate genes. To determine the contribution of genetic and environmental factors on the occurrence of T2DM, we examined the frequency of T2DM among two ethnically diverse populations, Arabs and Berbers, who have shared the same environment, the island of Djerba, for thousands of years. Both populations have a high prevalence of obesity,T2DM, and a high consanguinity rate. A total of 162 T2DM men and women were matched to 110 healthy male and female controls. Results showed that the NsiI polymorphism in INSR and BstnI polymorphism of IRS1 were significantly associated with T2DM only among the Berber group. The PstI polymorphism in INS, was not associated with T2DM in either group. Sedentary lifestyles, lower physical activity, and lower educational levels were associated with T2DM among the Berber group. These findings suggest that the insulin receptor gene and lifestyle factors in combination may contribute to the occurrence of T2DM in the Berber portion of this island population. PMID:23226034

  16. Living with diabetes: a group-based self-management support programme for T2DM patients in the early phases of illness and their partners, study protocol of a randomised comtrolled trial.

    NARCIS (Netherlands)

    Puffelen, A.L. van; Rijken, M.; Heijmans, M.J.W.M.; Nijpels, G.; Rutten, G.E.H.M.; Schellevis, F.G.

    2014-01-01

    Background: The present article presents the protocol for a randomised controlled trial to test the effectiveness of a group-based self-management support programme for recently diagnosed type 2 diabetes mellitus (T2DM) patients (one to three years post-diagnosis) and their partners. The course aims

  17. Living with diabetes: a group-based self-management support programme for T2DM patients in the early phases of illness and their partners, study protocol of a randomised controlled trial

    NARCIS (Netherlands)

    van Puffelen, A.L.; Rijken, M.; Heijmans, M.J.W.M.; Nijpels, G.; Rutten, G.E.H.M.; Schellevis, F.G.

    2014-01-01

    The present article presents the protocol for a randomised controlled trial to test the effectiveness of a group-based self-management support programme for recently diagnosed type 2 diabetes mellitus (T2DM) patients (one to three years post-diagnosis) and their partners. The course aims to support

  18. Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005

    DEFF Research Database (Denmark)

    Swift, P.G.F.; Skinner, T.C.; de Beaufort, C.E.

    2010-01-01

    Objective: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control. Methods: Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was ...

  19. Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2

    NARCIS (Netherlands)

    Hofsteenge, G.H.; Chin A Paw, M.J.M.; Weijs, P.J.M.; van Tulder, M.W.; Delemarre-van de Waal, H.A.

    2008-01-01

    Background. In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated. Methods. Go4it is a

  20. Subclinical Diabetes

    Directory of Open Access Journals (Sweden)

    LUÍS M.T.R. LIMA

    Full Text Available ABSTRACT Type 2 diabetes mellitus (T2DM is increasing in prevalence worldwide, and those non-diagnosed or misdiagnosed comprise a significant group compared to those diagnosed. Accumulated scientific evidence indicate that the current diagnostic markers (fasting glycemia, 2h glycemia after an oral glucose load and HbA1c are indeed late diagnostic criteria when considering the incidence of diabetes-related complications and comorbidities, which are also at high risk in some groups among normoglycemic individuals. Additionally, the earlier identification of future risk of diabetes is desirable since it would allow better adherence to preventive actions such as lifestyle intervention, ultimately avoiding complications and minimizing the economic impact/burden on health care expenses. Insulin resistance and hyperhormonemia (insulin, amylin, glucagon are non-disputable hallmarks of T2DM, which already takes place among these normoglycemic, otherwise health subjects, characterizing a state of subclinical diabetes. Insulin resistance and hyperinsulinemia can be computed from fasting plasma insulin as an independent variable in normoglycemia. An overview of the current diagnostic criteria, disease onset, complications, comorbidities and perspectives on lifestyle interventions are presented. A proposal for early detection of subclinical diabetes from routine evaluation of fasting plasma insulin, which is affordable and robust and thus applicable for the general population, is further suggested.

  1. COX-2 but not mPGES-1 contributes to renal PGE2 induction and diabetic proteinuria in mice with type-1 diabetes.

    Directory of Open Access Journals (Sweden)

    Zhanjun Jia

    Full Text Available Prostaglandin E2 (PGE2 has been implicated to play a pathogenic role in diabetic nephropathy (DN but its source remains unlcear. To elucidate whether mPGES-1, the best characterized PGE2 synthase, was involved in the development of DN, we examined the renal phenotype of mPGES-1 KO mice subjected to STZ-induced type-1 diabetes. After STZ treatment, mPGES-1 WT and KO mice presented the similar onset of diabetes as shown by similar elevation of blood glucose. Meanwhile, both genotypes of mice exhibited similar increases of urinary and renal PGE2 production. In parallel with this comparable diabetic status, the kidney injury indices including the urinary albumin excretion, kidney weight and the kidney histology (PAS staining did not show any difference between the two genotypes. By Western-blotting and quantitative qRT-PCR, mPGES-1, mPGES-2, cPGES and 15-hydroxyprostaglandin dehydrogenase (15-PGDH remain unaltered following six weeks of diabetes. Finally, a selective COX-2 inhibitor celecoxib (50 mg/kg/day was applied to the STZ-treated KO mice, which resulted in significant reduction of urinary albumin excretion (KO/STZ: 141.5±38.4 vs. KO/STZ + Celebrex: 48.7±20.8 ug/24 h, p<0.05 and the blockade of renal PGE2 induction (kidney: KO/STZ: 588.7±89.2 vs. KO/STZ + Celebrex: 340.8±58.7 ug/24 h, p<0.05; urine: KO/STZ 1667.6±421.4 vs. KO/STZ + Celebrex 813.6±199.9 pg/24 h, p<0.05, without affecting the blood glucose levels and urine volume. Taken together, our data suggests that an as yet unidentified prostaglanind E synthase but not mPGES-1 may couple with COX-2 to mediate increased renal PGE2 sythsesis in DN.

  2. Twelve-Month and Five-Year Analyses of Risk Factors for New-Onset Diabetes After Transplantation in a Group of Patients Homogeneous for Immunosuppression.

    Science.gov (United States)

    Dedinská, I; Laca, Ĺ; Miklušica, M; Galajda, P; Mokáň, M

    2015-01-01

    In the case of new-onset diabetes after transplantation (NODAT) development, it is suitable to reduce calcineurin inhibitors and corticosteroids. But change of immunosuppression can be counterproductive and can cause development of rejection and leads to further NODAT aggravation. We retrospectively evaluated risk factors after kidney transplantation. Comparison groups were homogeneous in terms of administered immunosuppression, and individual monitored parameters were not distorted by the immunosuppression administered. In the 12-month analysis we identified these risk factors for NODAT: age at the time of transplantation, 50-59 years (P = .0034); age at the time of transplantation, ≥ 60 years (P 0.15 g/d (P < .0002). In the 5-year analysis, we identified patients who were diagnosed with NODAT after the 1st year. We identified age ≥ 50 years at the time of transplantation to be an independent risk factors for NODAT. It is advisable to carry out the oral glucose tolerance test even in patients with physiologic levels of fasting glycemia. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. The potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education.

    Science.gov (United States)

    Stenov, Vibeke; Wind, Gitte; Skinner, Timothy; Reventlow, Susanne; Hempler, Nana Folmann

    2017-09-18

    Healthcare professionals' person-centered communication skills are pivotal for successful group-based diabetes education. However, healthcare professionals are often insufficiently equipped to facilitate person-centeredness and many have never received post-graduate training. Currently, assessing professionals' skills in conducting group-based, person-centered diabetes education primarily focus on experts measuring and coding skills on various scales. However, learner-centered approaches such as adequate self-reflective tools have been shown to emphasize professional autonomy and promote engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. The study entails of two components: 1) Field observations of five different educational settings including 49 persons with diabetes and 13 healthcare professionals, followed by interviews with 5 healthcare professionals and 28 persons with type 2 diabetes. 2) One professional development workshop involving 14 healthcare professionals. Healthcare professionals were asked to assess their person-centered communication skills using a self-assessment tool based on challenges and skills related to four educator roles: Embracer, Facilitator, Translator, and Initiator. Data were analyzed by hermeneutic analysis. Theories derived from theoretical model 'The Health Education Juggler' and techniques from 'Motivational Interviewing in Groups' were used as a framework to analyze data. Subsequently, the analysis from the field notes and interview transcript were compared with healthcare professionals' self-assessments of strengths and areas in need to effectively facilitate group-based, person-centered diabetes education. Healthcare professionals self-assessed the Translator and the Embracer to be the two most skilled roles whereas

  4. Frecuencia y características clínicas de la retinopatía diabética en un grupo de personas con diabetes mellitus tipo 2 de diagnóstico reciente Frequency and clinical characteristics of diabetic retinopathy in a group of persons recently diagnosed with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Manuel E. Licea Puig

    2003-08-01

    Full Text Available En los últimos años se le ha dedicado mayor atención a la presencia de complicaciones microangiopáticas en las personas con diabetes mellitus tipo 2 (DM 2, y la retinopatía diabética (RD no es una excepción. El objetivo de este trabajo es determinar la frecuencia y las características clínicas de la RD en un grupo de personas con DM 2 de diagnóstico reciente. Se estudiaron 110 pacientes (£ 6 meses con anticuerpos antiislotes pancreáticos (ICA y anti-descarboxilasa del ácido glutámico (AGAD negativos, atendidos consecutivamente en el Centro de Atención al Diabético (CAD, del Instituto Nacional de Endocrinología (INEN, y las variables utilizadas fueron: edad, sexo, hábito de fumar, índice de masa corporal (IMC, edad de debut de la DM 2, presencia de RD y de nefropatía diabética incipiente (NDI, así como la presión arterial. Se determinó ICA, AGAD, hemoglobina glucosilada (HbA1, glucemia en ayunas y posprandial 2 horas después del desayuno y 2 horas después del almuerzo y excreción urinaria de albúmina (EUA en orina de 24 horas. No se incluyó a pacientes con ND diabética clínica (EUA ³ 300 mg/L, ni con otras causas o condiciones de aumento de EUA. Se dividieron en 2 grupos atendiendo a la presencia o no de RD, así como a su severidad y fueron utilizados los criterios propuestos por L'Esperance. El 7 % de la totalidad de la serie presentó algún tipo de RD (7 no proliferativas y 1 proliferativa. La presión arterial sistólica fue de 127,84 ± 19,43 mmHg en aquellos sin RD y de 140 ± 15,27 mmHg , en los que presentaron RDNP (p 20 a In the last few years, great attention has been paid to microangiopathic complications occurred in persons with type 2 diabetes mellitus, and diabetic retinopathy is not the exception. The objective of this paper is to determine the frequency and the clinical characteristics of diabetic retinopathy in a group of persons recently diagnosed with type 2 diabetes mellitus. One hundred ten

  5. Differential impact of statin on new-onset diabetes in different age groups: a population-based case-control study in women from an asian country.

    Directory of Open Access Journals (Sweden)

    Chih-Wei Chen

    Full Text Available BACKGROUND: Statins reduce cardiovascular risks but increase the risk of new-onset diabetes (NOD. The aim of this study is to determine what effect, if any, statins have on the risk of NOD events in a population-based case-control study. An evaluation of the relationship between age and statin-exposure on NOD risks was further examined in a female Asian population. METHOD: In a nationwide case-controlled study, the authors assessed 1065 female NOD patients and 10650 controls with matching ages, genders and physician visit dates. The impact of statin-exposure on NOD was examined through multiple logistic regression models. Subgroup analysis for exploring the risk of NOD and statin-exposure in different age groups was performed. RESULTS: Statin-exposure was statistically significantly associated with increased new-onset diabetes risks using multivariate analysis. Interaction effect between age and statin-exposure on NOD risk was noted. For atorvastatin, the risk of cDDDs>60 was highest among the 55-64 year-olds (adjusted odds ratio [OR], 8.0; 95% confidence interval [CI], 2.57-24.90. For rosuvastatin, the risk of cDDDs>60 was highest among the 40-54 year-olds (adjusted OR, 14.8; 95% CI, 2.27-96.15. For simvastatin, the risk of cDDDs>60 was highest among the 55-64 year-olds (adjusted OR, 15.8; 95% CI, 5.77-43.26. For pravastatin, the risk of cDDDs>60 was highest among the 55-64 year-olds (adjusted OR, 14.0; 95% CI, 1.56-125.18. CONCLUSIONS: This population-based study found that statin use is associated with an increased risk of NOD in women. The risk of statin-related NOD was more evident for women aged 40-64 years compared to women aged 65 or more, and was cumulative-dose dependent. The use of statins should always be determined by weighing the clinical benefits and potential risks for NOD, and the patients should be continuously monitored for adverse effects.

  6. Comorbidities, complications and mortality in people of South Asian ethnicity with type 1 diabetes compared with other ethnic groups: a systematic review.

    Science.gov (United States)

    Sarwar, Komil N; Cliff, Phoebe; Saravanan, Ponnusamy; Khunti, Kamlesh; Nirantharakumar, Krishnarajah; Narendran, Parth

    2017-07-13

    The aim of this systematic review is to explore the association of South Asian (SA) ethnicity on comorbidities, microvascular and macrovascular complications and mortality compared with other ethnic groups in people with type 1 diabetes mellitus (T1DM). Systematic review. A systematic literature search strategy was designed and carried out using Medline and Embase for full-text and abstract studies published in English from 1946 to February 2016. The initial search identified 4722 papers. We assessed 305 full-text articles in detail for potential inclusion. Ten papers met the inclusion criteria for review and an additional one paper was included from our secondary search strategy using the bibliography of included studies. In total, 11 studies were included. Studies were included if they were published in English, involved SA participants with T1DM and compared them with non-SA participants and assessed one of the outcomes of comorbidities, microvascular complications, macrovascular complications and mortality. SA with T1DM have higher mortality compared with white Europeans (WE), mainly contributed to by excess cardiovascular disease. SA have significantly higher glycated haemoglobin (HbA1c), lower high-density lipoprotein (HDL) and lower rates of neuropathy compared with WE. There were no differences in rates of retinopathy and nephropathy. Compared with Africans, SA had lower levels of microalbuminuria, HbA1c and systolic blood pressure and higher HDL levels. There were no significant differences in the remaining outcomes: cardiovascular disease, retinopathy, neuropathy and body mass index. Furthermore, SA have higher HbA1c levels than Malay and Chinese and higher waistâ€"hip ratio and lower HDL levels compared with Chinese only. Our analysis highlights ethnic disparity in macrovascular outcomes that is so evident for type 2 diabetes mellitus may also be present for SA patients with T1DM. We highlight the need for a large, prospective, cohort study exploring

  7. [Usual physical activity level, glycemic control, and cardiovascular risk factors profile. Spanish Diabetes Society Working Group for the study of Nutrition].

    Science.gov (United States)

    1998-06-01

    To know the relation between the usual physical activity pattern and metabolic control and cardiovascular risk factors of people with diabetes mellitus. 144 type 1 (insulin dependent) diabetic subjects (M/F, 70/74) and 193 type 2 (non insulin dependent) diabetic patients 8M/F, 81/112) fron DNCT study (Diabetes Nutrition and Complications Trial) were included in the study from May 1993 to December 1994. Physical activity index was assessed by means of the weekly caloric expenditure based upon previously published questionnaire. At least 60% of diabetic patients had a regular exercise more than 3 times per week. Unexpected, level of HbA1c, but not other parameters, was related to the level of physical activity, in that the higher the activity the higher HbA1c level in both type 1 and type 2 diabetic patients. In the DNCT study the higher physical activity level was associated a worsening in the HbA1c level. These un expected date there are take into account when recommending physical activity to people with diabetes mellitus with no good metabolic control.

  8. A group randomized trial of a complexity-based organizational intervention to improve risk factors for diabetes complications in primary care settings: study protocol

    Directory of Open Access Journals (Sweden)

    Noel Polly H

    2008-03-01

    Full Text Available Abstract Background Most patients with type 2 diabetes have suboptimal control of their glucose, blood pressure (BP, and lipids – three risk factors for diabetes complications. Although the chronic care model (CCM provides a roadmap for improving these outcomes, developing theoretically sound implementation strategies that will work across diverse primary care settings has been challenging. One explanation for this difficulty may be that most strategies do not account for the complex adaptive system (CAS characteristics of the primary care setting. A CAS is comprised of individuals who can learn, interconnect, self-organize, and interact with their environment in a way that demonstrates non-linear dynamic behavior. One implementation strategy that may be used to leverage these properties is practice facilitation (PF. PF creates time for learning and reflection by members of the team in each clinic, improves their communication, and promotes an individualized approach to implement a strategy to improve patient outcomes. Specific objectives The specific objectives of this protocol are to: evaluate the effectiveness and sustainability of PF to improve risk factor control in patients with type 2 diabetes across a variety of primary care settings; assess the implementation of the CCM in response to the intervention; examine the relationship between communication within the practice team and the implementation of the CCM; and determine the cost of the intervention both from the perspective of the organization conducting the PF intervention and from the perspective of the primary care practice. Intervention The study will be a group randomized trial conducted in 40 primary care clinics. Data will be collected on all clinics, with 60 patients in each clinic, using a multi-method assessment process at baseline, 12, and 24 months. The intervention, PF, will consist of a series of practice improvement team meetings led by trained facilitators over 12

  9. High-Mobility Group Box-1 Protein Mediates the Regulation of Signal Transducer and Activator of Transcription-3 in the Diabetic Retina and in Human Retinal Müller Cells.

    Science.gov (United States)

    Mohammad, Ghulam; Jomar, Deema; Siddiquei, Mohammad Mairaj; Alam, Kaiser; Abu El-Asrar, Ahmed M

    2017-01-01

    The expression of high-mobility group box-1 (HMGB1) and signal transducer and activator of transcription-3 (STAT-3) is upregulated in the diabetic retina. We hypothesized that the activation of STAT-3 is under the control of HMGB1. Retinas from 1-month-old diabetic rats and from normal rats intravitreally injected with HMGB1 and human retinal Müller glial cells (MIO-M1) stimulated with HMGB1 or high glucose were studied by Western blot analysis and immunofluorescence. We also studied the effect of the HMGB1 inhibitor glycyrrhizin (GA) on high-glucose-induced pSTAT-3 nuclear translocation and upregulation in Müller cells and on pSTAT-3 expression in the retinas of diabetic rats (n = 7-10 in each group). In addition, we studied the effect of STAT-3 inhibitor on the HMGB1-induced induction of vascular endothelial growth factor (VEGF) by Müller cells and human retinal microvascular endothelial cell (HRMEC) migration. Treatment of retinal Müller cells with recombinant HMGB1 induced nuclear translocation of pSTAT-3 but did not alter pSTAT-3 expression. High glucose induced a significant upregulation of HMGB1 and pSTAT-3 upregulation and nuclear translocation in retinal Müller cells. GA co-treatment normalized the high-glucose-induced upregulation of HMGB1 and pSTAT-3 upregulation and nuclear translocation in Müller cells. Intravitreal administration of HMGB1 in normal and diabetic rats upregulated pSTAT-3 expression in the retina. GA attenuated the diabetes-induced upregulation of pSTAT-3 in the retina. The STAT-3 inhibitor attenuated HMGB1-induced VEGF upregulation by Müller cells and HRMEC migration. The results suggest a role for HMGB1 in the modulation of STAT-3 expression in the diabetic retina. © 2016 S. Karger AG, Basel.

  10. Region-Specific Vulnerability to Oxidative Stress, Neuroinflammation, and Tau Hyperphosphorylation in Experimental Diabetes Mellitus Mice.

    Science.gov (United States)

    Elahi, Montasir; Hasan, Zafrul; Motoi, Yumiko; Matsumoto, Shin-Ei; Ishiguro, Koichi; Hattori, Nobutaka

    2016-01-01

    Recent epidemiological evidence suggests that diabetes mellitus (DM) is a risk factor for Alzheimer's disease (AD). One of the pathological hallmarks of AD is hyperphosphorylated tau protein, which forms neurofibrillary tangles. Oxidative stress and the activation of inflammatory pathways are features that are associated with both DM and AD. However, the brain region specificity of AD-related neurodegeneration, which mainly occurs in the hippocampus while the cerebellum is relatively unaffected, has not yet been clarified. Therefore, we used experimental DM mice (caused by an intraperitoneal injection of streptozotocin [STZ]) to determine whether these neurodegeneration-associated mechanisms were associated with region-specific selective vulnerability or tau phosphorylation. The hippocampus, midbrain, and cerebellum of aged (14 to 18 months old) non-transgenic (NTg) and transgenic mice overexpressing wild-type human tau (Tg601 mice) were evaluated after a treatment with STZ. The STZ injection increased reactive oxygen species, lipid peroxidation markers such as 4-hydroxynonenal and malondialdehyde in the hippocampus, but not in the midbrain or cerebellum. The STZ treatment also increased the number of Iba-1-positive and CD68-positive microglial cells, astrocytes, and IL-1β, IL-6, IL-10, and IL-18 levels in the hippocampus, but not in the midbrain or cerebellum. Tau hyperphosphorylation was also enhanced in the hippocampus, but not in the midbrain or cerebellum. When the effects of STZ were compared between Tg601 and NTg mice, microglial proliferation and elevations in IL-6 and phosphorylated tau were higher in Tg601 mice. These results suggest that neuroinflammation and oxidative stress in STZ-treated mice are associated with tau hyperphosphorylation, which may contribute to selective neurodegeneration in human AD.

  11. Influence of socioeconomic lifestyle factors and genetic polymorphism on type 2 diabetes occurrences among Tunisian Arab and Berber groups of Djerba Island

    Directory of Open Access Journals (Sweden)

    Thouraya Baroudi Ouederni

    2009-08-01

    Full Text Available Thouraya Baroudi Ouederni1, Ahmed Fadiel2,3, Nejla Stambouli1, Trudy J Scalize3, Hedi Ben Maiz4, Hafaona Kammoun Abid1, Rim Bouhaha1, Jose Sanchez-Corona5, Adel Hamza1,6*, Amel Benammar-Elgaaied1,*1Laboratory of Genetics, Immunology and Human Pathology, Faculty of Sciences of Tunis, Tunis, Tunisia; 2New York University School of Medicine, NYU Medical Center, New York, NY, USA; 3Biomedical Informatics, OBGYN Department, Meharry Medical College, Nashville, TN, USA; 4Charles Nicolle Hospital, Internal Medicine A, Tunis, Tunisia; 5División de Medecina Molecular, Centro de Investigación Biomédica de Occidente, Instituto Mexicano Del Seguro Social, Guadalajara, Jalisco, México; 6Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY, USA; *These authors contributed equally to this work and are the corresponding authorsAbstract: Type 2 diabetes mellitus (T2DM is characterized by three major metabolic abnormalities: impaired insulin-stimulated glucose uptake in muscle and adipose tissues, alterations in glucose-stimulated insulin secretion, and increased hepatic glucose production. Both genetic and environmental factors contribute to its development. The insulin gene (INS, insulin receptor gene (INSR, and insulin receptor substrate 1 gene (IRS1, identified by polymerase chain reaction and digestion with selected restriction enzymes PstI, NsiI, and BstnI, have been proposed as T2DM candidate genes. To determine the contribution of genetic and environmental factors on the occurrence of T2DM, we examined the frequency of T2DM among two ethnically diverse populations, Arabs and Berbers, who have shared the same environment, the island of Djerba, for thousands of years. Both populations have a high prevalence of obesity, T2DM, and a high consanguinity rate. A total of 162 T2DM men and women were matched to 110 healthy male and female controls. Results showed that the NsiI polymorphism in INSR and Bstn

  12. Translational study of obesity management using the Diabetes Prevention Program "Group Lifestyle Balance" in primary care clinics and public hospitals from Mexico: study protocol

    Directory of Open Access Journals (Sweden)

    Rolando Giovanni Díaz-Zavala

    2017-12-01

    Full Text Available Introduction: Obesity is the main modifiable risk factor for the development of chronic diseases in Mexico. Several randomized controlled trials have shown that intensive lifestyle programs are efficacious for the management of obesity. These programs include frequent sessions (14 or more contacts in the first 6 months focused on diet and physical activity and use a behavior change protocol. However, most Mexican primary care clinics and public hospitals apply traditional treatments for obesity management with limited results on weight loss. The purpose of the study is to evaluate the effectiveness of the Diabetes Prevention Program (DPP “Group Lifestyle Balance” for weight loss among adults with overweight and obesity from baseline to 6 months and from baseline to 12 months in primary care clinics and public hospitals from Sonora, Mexico. Material and Methods: This is a translational, multi-center, non-controlled, 6 and 12-month follow-up clinical study with a pre-test and post-test design. Healthcare providers from two primary care clinics, two hospitals and one university clinic will be trained with the DPP protocol to implement on their patients with overweight and obesity. Body weight, body mass index, waist circumference, systolic and diastolic blood pressure, depression, quality of life and stress scales will be measured in participants receiving the program at baseline, 6 and 12 months. Biochemical parameters will be measured at baseline and 12 months. The primary outcome is the change in body weight at 6 and 12 months. Discussion: This study will provide scientific evidence of the effectiveness of the DPP protocol as a model for obesity management in real world clinical practice among the adult Mexican population.

  13. A priori-defined diet quality indices, biomarkers and risk for type 2 diabetes in five ethnic groups: the Multiethnic Cohort.

    Science.gov (United States)

    Jacobs, Simone; Boushey, Carol J; Franke, Adrian A; Shvetsov, Yurii B; Monroe, Kristine R; Haiman, Christopher A; Kolonel, Laurence N; Le Marchand, Loic; Maskarinec, Gertraud

    2017-08-01

    Dietary indices have been related to risk for type 2 diabetes (T2D) predominantly in white populations. The present study evaluated this association in the ethnically diverse Multiethnic Cohort and examined four diet quality indices in relation to T2D risk, homoeostatic model assessment-estimated insulin resistance (HOMA-IR) and biomarkers of dyslipidaemia, inflammation and adipokines. The T2D analysis included 166 550 white, African American, Native Hawaiian, Japanese American and Latino participants (9200 incident T2D cases). Dietary intake was assessed at baseline using a quantitative FFQ and T2D status was based on three self-reports and confirmed by administrative data. Biomarkers were assessed about 10 years later in a biomarker subcohort (n 10 060). Sex- and ethnicity-specific hazard ratios were calculated for the Healthy Eating Index-2010 (HEI-2010), the alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED) and the Dietary Approaches to Stop Hypertension (DASH). Multivariable-adjusted means of biomarkers were compared across dietary index tertiles in the biomarker subcohort. The AHEI-2010, aMED (in men only) and DASH scores were related to a 10-20 % lower T2D risk, with the strongest associations in whites and the direction of the relationships mostly consistent across ethnic groups. Higher scores on the four indices were related to lower HOMA-IR, TAG and C-reactive protein concentrations, not related to leptin, and the DASH score was directly associated with adiponectin. The AHEI-2010 and DASH were directly related to HDL-cholesterol in women. Potential underlying biological mechanisms linking diet quality and T2D risk are an improved lipid profile and reduced systemic inflammation and, with regards to DASH alone, an improved adiponectin profile.

  14. Diabetic Hypoglycemia

    Science.gov (United States)

    ... medication or your dosage or otherwise adjust your diabetes treatment program. Request an Appointment at Mayo Clinic Causes ... Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood. ...

  15. The effect of guided self-determination on self-management in persons with type 1 diabetes mellitus and HbA1c ≥64 mmol/mol: a group-based randomised controlled trial.

    Science.gov (United States)

    Mohn, Jannike; Graue, Marit; Assmus, Jõrg; Zoffmann, Vibeke; Thordarson, Hrafnkell; Peyrot, Mark; Rokne, Berit

    2017-07-03

    To determine whether the impact of guided self-determination (GSD) applied in group training (GSD-GT) in people with chronically elevated HbA1c and type 1 diabetes mellitus (DM) was superior to 'care as usual' in improving HbA1c and psychological functioning. An outpatient clinic at a university hospital in Western Norway. A total of 178 adults (all Caucasian) aged 18-55 (mean age 36.7±10.7, 62% women) with type 1 DM for at least 1 year and HbA1c ≥64 mmol/mol (8.0%) were randomly assigned to participate in either GSD-GT or a control group (CG). Exclusion criteria were severe comorbidity, major psychiatric disorder, cognitive deficiency/language barriers and pregnancy. Intervention group met seven times for 2 hours over 14 weeks to promote patient autonomy and intrinsic motivation using reflection sheets and advanced professional communication in accordance with the GSD methodology. The primary outcome was HbA1c and secondary outcomes (all outcomes 9 months post intervention) were self-monitored blood glucose frequency, self-reported diabetes competence, autonomy support by healthcare providers (Health Care Climate Questionnaire), autonomous versus controlled diabetes motivation (Treatment Self-Regulation Questionnaire), diabetes distress (Problem Areas In Diabetes Scale (PAID) and Diabetes Distress Scale (DDS)), self-esteem (Rosenberg Self-Esteem Scale) and psychological well-being (World Health Organization five-item Well-Being Index scale). Among participants allocated to the GSD-GT (=90) 48 completed the study, whereas 83 completed in the CG (n=88). With 95% CIs GSD-GT did not have effect on HbA1c (B -0.18, CI (-0.48, 0.12), p=0.234). GSD-GT improved autonomy-motivated behaviour (B 0.51, CI (0.25, 0.77), pself-esteem (B 1.43, CI (0.34, 2.52), p=0.011). Results from this behavioural intervention must be interpreted cautiously because of recruitment and attrition problems. Medical outcomes did not improve. Psychological outcomes improved, especially reduced

  16. Trastornos metabólicos asociados con la evolución hacia la diabetes mellitus tipo 2 en una población en riesgo Metabolic disorders associated with the evolution to type 2 diabetes mellitus in a risk group

    Directory of Open Access Journals (Sweden)

    Roberto M. González Suárez

    2010-08-01

    diabetes mellitus tipo 2, por lo que en este grupo es necesario intensificar las medidas para revertir o enlentecer el deterioro metabólico. En el grupo con alto riesgo de diabetes y tolerancia a la glucosa normal, el único factor metabólico identificado como marcador pronóstico de la progresión hacia la diabetes es la baja respuesta insulínica. Se recomienda incorporar la evaluación de la capacidad funcional de la célula beta para la detección precoz de personas en riesgo de padecer diabetes.ABSTRACT INTRODUCTION: the clinical and metabolic state of persons in risk of suffer type 2 diabetes mellitus (DM2 is very heterogeneous. OBJECTIVE: to identify the factors influencing in progression to diabetes in subgroups of patients with different types and the severity of metabolic disorders. METHODS: a prospective study was conducted in 209 subjects in high risk of progression to type 2 diabetes mellitus (backgrounds of disorders related to glucose tolerance without fasting hyperglycemia to examine the metabolic disorders associating with progression to diabetes. Glucose tolerance, insulin secretion and insulin sensitivity were studied at onset and two years later. RESULTS: we found that the risk to develop diabetes mellitus was in a significant dependence of the deterioration degree of glucose tolerance present in the initial study (normal glucose tolerance, 10 %; altered glucose tolerance, 14,6 %; altered glucose tolerance + altered fasting glycemia, 56,7 %. In the group with a normal glucose tolerance the fundamental predictive factor of evolution to diabetes mellitus was the failure of initial insulin secretory response (OR: 8,13; 95 % CI; 1,83 to 36,0. In the subjects with altered glucose tolerance with fasting altered glycemia and without it, determinant factor was the fasting glycemia (OR: 5,41; 95 % CI; 2,15 to 13,6. The insulin resistance was not a significant predictive factor in any study subgroups. CONCLUSIONS: postprandial glycemia disorders in early stages

  17. The potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education

    DEFF Research Database (Denmark)

    Stenov, Vibeke; Wind, Gitte; Skinner, Timothy

    2017-01-01

    , assessing professionals’ skills in conducting group-based, person-centered diabetes education primarily focus on experts measuring and coding skills on various scales. However, learner-centered approaches such as adequate self-reflective tools have been shown to emphasize professional autonomy and promote...... to observations of professional skills in educational programs and were confirmed in the interviews. Conclusion: Healthcare professionals self-assessed the same professional skills as observed in practice. Thus, a tool to self-assess professional skills in facilitating group-based diabetes education seems...... to be useful as a starting point to promote self-reflections and identification of healthcare professionals’ strengths and areas of need of professional development....

  18. The potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education

    DEFF Research Database (Denmark)

    Stenov, Vibeke; Wind, Gitte; Skinner, Timothy

    2017-01-01

    BACKGROUND: Healthcare professionals' person-centered communication skills are pivotal for successful group-based diabetes education. However, healthcare professionals are often insufficiently equipped to facilitate person-centeredness and many have never received post-graduate training. Currently...... engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. METHODS: The study entails of two components....... Healthcare professionals were asked to assess their person-centered communication skills using a self-assessment tool based on challenges and skills related to four educator roles: Embracer, Facilitator, Translator, and Initiator. Data were analyzed by hermeneutic analysis. Theories derived from theoretical...

  19. Women and Diabetes -- Diabetes Medicines

    Science.gov (United States)

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  20. Moving to an A1C-based diagnosis of diabetes has a different impact on prevalence in different ethnic groups

    DEFF Research Database (Denmark)

    Christensen, Dirk L; Witte, Daniel R; Kaduka, Lydia

    2010-01-01

    OBJECTIVE To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. RESEARCH DESIGN AND METHODS Six studies (1999-2009) from Denmark, the U.K......., Australia, Greenland, Kenya, and India were tested for the probability of an A1C > or =6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. RESULTS Diabetes prevalence was lower with the A1C......-based diagnostic criteria in four of six studies. The probability of an A1C > or =6.5% among OGTT-diagnosed case subjects ranged widely (17.0-78.0%) by study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. study were of the same magnitude as between-country comparisons. CONCLUSIONS...

  1. Urinary albumin excretion in a population based sample of 1011 middle aged non-diabetic subjects. The Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Jensen, J S; Feldt-Rasmussen, B; Borch-Johnsen, K

    1993-01-01

    in the non-diabetic population. Among 1011 30-70-year-old subjects without diabetes mellitus or urinary tract infection, who were invited to participate in a population based epidemiological study, the albumin concentration was measured in an overnight urine sample. The measurement was performed by an ELISA...... constant with age, but males had higher UAER than females, 2.6 (0-13.5) micrograms min-1 vs 2.2 (0-8.3) micrograms min-1; p sample, was 3% (95% C.I. interval: 1...

  2. Urinary albumin excretion in a population based sample of 1011 middle aged non-diabetic subjects. The Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Jensen, J S; Feldt-Rasmussen, B; Borch-Johnsen, K

    1993-01-01

    Increased urinary albumin excretion rate (UAER) especially in the range of 20-200 micrograms min-1, termed microalbuminuria, has been proposed as a risk marker and predictor for cardiovascular disease in non-diabetic subjects. Thus it would be of importance to describe the distribution of UAER.......9-4.0). These findings suggest, that the level of UAER which might notify increased cardiovascular risk, is lower than in patients with diabetes mellitus, if it is considered to be of any clinical relevance....

  3. Plasma C1q/TNF-Related Protein-3 (CTRP-3 and High-Mobility Group Box-1 (HMGB-1 Concentrations in Subjects with Prediabetes and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Huili Wei

    2016-01-01

    Full Text Available Aims. To detect the association of C1q/TNF-related protein-3 (CTRP-3 and high-mobility group box-1 (HMGB-1 in subjects with prediabetes (pre-DM and newly diagnosed type 2 diabetes (nT2DM. Methods. 224 eligible participants were included. The 75 g oral glucose tolerance test (OGTT and several clinical parameters of metabolic disorders and cytokines were measured. All participants were divided into three groups: normal glucose tolerance (NGT, n=62, pre-DM (n=111, and nT2DM group (n=56. Results. Plasma CTRP-3 concentrations were significantly lower in subjects with pre-DM and nT2DM than that of the NGT group, while plasma HMGB-1 levels were higher in pre-DM and nT2DM group compared with the NGT group (P<0.05. A multiple linear regression analysis showed both plasma CTRP-3 and HMGB-1 concentrations were independently associated with homeostasis model assessment for insulin resistance (HOMA-IR and interleukin-6 (IL-6 (P<0.05 for all. Further multiple logistical regression analyses revealed that both plasma CTRP-3 and HMGB-1 levels were significantly associated with pre-DM and nT2DM after adjusting for several confounders (P<0.001 for all. Conclusions. Circulating CTRP-3 and HMGB-1 concentrations might be promising biomarkers to predict prediabetes and type 2 diabetes.

  4. Urinary albumin excretion in a population based sample of 1011 middle aged non-diabetic subjects. The Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Jensen, J S; Feldt-Rasmussen, B; Borch-Johnsen, K

    1993-01-01

    Increased urinary albumin excretion rate (UAER) especially in the range of 20-200 micrograms min-1, termed microalbuminuria, has been proposed as a risk marker and predictor for cardiovascular disease in non-diabetic subjects. Thus it would be of importance to describe the distribution of UAER...

  5. Assessment of quality of life with the WHOQOL-BREF in a group of Turkish psychiatric patients compared with diabetic and healthy subjects.

    Science.gov (United States)

    Akvardar, Yildiz; Akdede, Berna Binnur; Ozerdem, Ayşegül; Eser, Erhan; Topkaya, Sule; Alptekin, Köksal

    2006-12-01

    Decreased quality of life is often an important cause or consequence of psychiatric illness, and needs to be included in a comprehensive treatment plan. The authors aimed to identify how psychiatric patients characterize the quality of their lives compared to others who are suffering from a chronic physical illness (diabetes) and healthy individuals. A total of 100 psychiatric patients were recruited from Dokuz Eylül University Psychiatry Department outpatient clinic. Of these, 34 had 4(th) edition Diagnostic and Statistical Manual diagnosis of alcohol dependence, 38 had schizophrenia, and 28 had bipolar disorder. A total of 35 patients with diabetes and 49 healthy individuals were also included in the study. The World Health Organization's Quality of Life Questionnaire was used to measure the quality of life. Patients with alcohol dependence, bipolar disorder, and schizophrenia scored lower than healthy subjects on the physical aspects of quality of life. Patients with schizophrenia had lower scores in the psychological domain compared to patients with bipolar disorder, patients with diabetes, and healthy subjects. In the social relationship domain, patients with schizophrenia and alcohol dependence scored lower compared to healthy subjects. Patients with schizophrenia were worse with respect to social relationships than bipolar patients and diabetics. World Health Organization's Quality of Life Questionnaire is useful for evaluating the needs and targets for interventions in psychiatric patients.

  6. Non-insulin-dependent diabetes mellitus is associated with a greater prevalence of depression in the elderly. The Osservatorio Geriatrico of Campania Region Group.

    Science.gov (United States)

    Amato, L; Paolisso, G; Cacciatore, F; Ferrara, N; Canonico, S; Rengo, F; Varricchio, M

    1996-10-01

    We investigated the association of non-insulin-dependent (Type 2) diabetes mellitus and depression symptoms in a representative community-dwelling elderly population independently of other conditions such as gender, age, status, disability, cognitive impairment and a number of chronic medical conditions such as chronic obstructive lung disease, degenerative joint disease, heart disease, cirrhosis of the liver, cholelithiasis, peptic ulcer and kidney stones. A total of 1339 elderly subjects living in southern Italy were randomly selected from electoral rolls and evaluated. All subjects were tested by the Geriatric Depression Scale to detect depression, the Mini-Mental State Examination to study cognitive function and the Activity Daily Living Index to evaluate disability. Non-insulin-dependent diabetes mellitus affected 14.7% of our sample. Depression was more prevalent in women over 75 years of age than in younger women (15.9 vs 8.1%, p < 0.001). In multiple linear regression analysis, diabetes mellitus was found to be significantly associated with depression independently of age, gender, loneliness, cognitive impairment, chronic obstructive lung disease, degenerative joint disease, heart diseases, cancer, kidney disease, cirrhosis of the liver and cholelithiasis. It is concluded that non-insulin-dependent diabetes mellitus is significantly associated with depression in the elderly, which may have clinical implications for the achievement of sufficient blood glucose control.

  7. Accelerating impact of diabetes mellitus on mortality in the years following an acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Melchior, T; Køber, Lars Valeur; Madsen, C R

    1999-01-01

    AIMS: The development of risk associated with diabetes mellitus during long-term follow-up after a myocardial infarction has not been studied in detail. We have studied time-related changes of risk of death during 10 years of follow-up in a cohort of patients not treated with thrombolytic therapy...... between day 0 and day 30 was 1.17 and increased to 2.51 (P=0.0002) 7-9 years after discharge from hospital. A similar increase in the risk ratio of diabetes mellitus on mortality was observed in the TRACE cohort (risk ratio for days 0-30 was 1.03, and for years 4-6 was 1.74 (P=0.0001). CONCLUSION...... and follow-up was for 6 years. Outcome measure was total death. RESULTS: A diagnosis of diabetes mellitus was present in 12% of the two study populations. In multivariate analysis, diabetes mellitus had an independent adverse effect on mortality which increased with time. In the Glostrup cohort risk ratio...

  8. Incidence of register-based diabetes 10 years after a stepwise diabetes screening programme

    DEFF Research Database (Denmark)

    Rasmussen, S. S.; Johansen, Nanna; Witte, D. R.

    2016-01-01

    criteria. Seven incremental levels of diabetes risk were defined and followed for incident diabetes recorded in the Danish National Diabetes Register until December 2012. For each group, cumulative diabetes incidence was calculated. Incidence rates and rate ratios were estimated by Poisson regression......Aims/hypothesis: Screening programmes for type 2 diabetes inevitably find more people at high risk of developing diabetes than people with undiagnosed prevalent diabetes. We describe the incidence of diabetes for risk groups according to advancement in a screening process. Methods: In 2001......–2006, a diabetes screening programme based on the Danish diabetes risk score and measures of HbA1c and glucose was carried out in Danish general practices. The present study includes 13,249 individuals with low diabetes risk scores and 22,726 with high diabetes risk scores but no diabetes according to WHO 1999...

  9. Ethnicity-specific obesity cut-points in the development of Type 2 diabetes - a prospective study including three ethnic groups in the United Kingdom.

    Science.gov (United States)

    Tillin, T; Sattar, N; Godsland, I F; Hughes, A D; Chaturvedi, N; Forouhi, N G

    2015-02-01

    Conventional definitions of obesity, e.g. body mass index (BMI) ≥ 30 kg/m² or waist circumference cut-points of 102 cm (men) and 88 cm (women), may underestimate metabolic risk in non-Europeans. We prospectively identified equivalent ethnicity-specific obesity cut-points for the estimation of diabetes risk in British South Asians, African-Caribbeans and Europeans. We studied a population-based cohort from London, UK (1356 Europeans, 842 South Asians, 335 African-Caribbeans) who were aged 40-69 years at baseline (1988-1991), when they underwent anthropometry, fasting and post-load (75 g oral glucose tolerance test) blood tests. Incident Type 2 diabetes was identified from primary care records, participant recall and/or follow-up biochemistry. Ethnicity-specific obesity cut-points in association with diabetes incidence were estimated using negative binomial regression. Diabetes incidence rates (per 1000 person years) at a median follow-up of 19 years were 20.8 (95% CI: 18.4, 23.6) and 12.0 (8.3, 17.2) in South Asian men and women, 16.5 (12.7, 21.4) and 17.5 (13.0, 23.7) in African-Caribbean men and women, and 7.4 (6.3, 8.7), and 7.2 (5.3, 9.8) in European men and women. For incidence rates equivalent to those at a BMI of 30 kg/m² in European men and women, age- and sex-adjusted cut-points were: South Asians, 25.2 (23.4, 26.6) kg/m²; and African-Caribbeans, 27.2 (25.2, 28.6) kg/m². For South Asian and African-Caribbean men, respectively, waist circumference cut-points of 90.4 (85.0, 94.5) and 90.6 (85.0, 94.5) cm were equivalent to a value of 102 cm in European men. Waist circumference cut-points of 84.0 (74.0, 90.0) cm in South Asian women and 81.2 (71.4, 87.4) cm in African-Caribbean women were equivalent to a value of 88 cm in European women. In prospective analyses, British South Asians and African-Caribbeans had equivalent diabetes incidence rates at substantially lower obesity levels than the conventional European cut-points. © 2014 The Authors. Diabetic

  10. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and beta-cell function in type 2 diabetes: a parallel-group study

    DEFF Research Database (Denmark)

    Zander, Mette; Madsbad, Sten; Madsen, Jan Lysgaard

    2002-01-01

    BACKGROUND: Glucagon-like peptide 1 (GLP-1) has been proposed as a treatment for type 2 diabetes. We have investigated the long-term effects of continuous administration of this peptide hormone in a 6-week pilot study. METHODS: 20 patients with type 2 diabetes were alternately assigned continuous...... subcutaneous infusion of GLP-1 (n=10) or saline (n=10) for 6 weeks. Before (week 0) and at weeks 1 and 6, they underwent beta-cell function tests (hyperglycaemic clamps), 8 h profiles of plasma glucose, insulin, C-peptide, glucagon, and free fatty acids, and appetite and side-effect ratings on 100 mm visual......-cell function (defined as the first-phase response to glucose and the maximum insulin secretory capacity of the cell). Analyses were per protocol. FINDINGS: One patient assigned saline was excluded because no veins were accessible. In the remaining nine patients in that group, no significant changes were...

  11. Cardiovascular consequences of diabetes mellitus

    NARCIS (Netherlands)

    C.A. Baan (Caroline)

    1999-01-01

    textabstractDiabetes mellitus comprises a clinically and genetically heterogeneous group of disorders that have one common feature: abnormally high levels of glucose in the blood. The most common form is non-insulin dependent diabetes mellitus (NlDDM); about 80-90% of all diabetic patients has

  12. Diabetes mellitus

    OpenAIRE

    Nessim Dayan, Edgard; Fundación Valle de Lili

    1996-01-01

    ¿Qué es la diabetes?/¿Cuantos tipos o formas de diabetes existen?/¿Cuáles son los síntomas de la diabetes?/¿cuál es la causa de la diabetes?/¿Quién tiene mayor riesgo de desarrollar diabetes?/¿Cómo se diagnostica la diabetes?/¿Cuál es el tratamiento de la diabetes?/¿Cuándo y cómo se controlan los niveles de glicemia?/¿Cuáles son las complicaciones de la diabetes?/Recomendaciones actuales y futuro de la diabetes.

  13. Variantes polimórficas Ala513Pro y Gly972Arg del gen IRS-1 no se asocian a la diabetes mellitus tipo 2 en un grupo de la población cubana The Ala513Pro and Gly972ARg polymorphous variants of IRS-1 gen are not associated with type diabetes mellitus in a group of the Cuban population

    Directory of Open Access Journals (Sweden)

    Luis Miguel Pérez

    2011-08-01

    this disease in different populations. Objective: to explore the role of the Gly972Arg and Ala513PRo of IRS-1 gen polymorphous variants in the genetic susceptibility of type 2 diabetes mellitus in Cuban population. Methods: the frequency of above mentioned polymorphous variants in 499 Cuban citizens with a 22-30 body mass index aged between 40 to 70 including 272 diabetics (54,5 % and 227 non-diabetic (45,5 %. Results: frequency of Pro513 allele was low (1,2 % and similar en both groups (1,1 % versus 1,3 % for diabetic group and the control one, respectively. Frequency of Gly972Arg polymorphism was of 16,2 %, higher than that reported for most of study populations. There were not significant differences in frequency of Arg972 allele between the diabetic group and the control one (15,4 % versus 17,3 %. Also, there were not changes in glycemia and insulinemia levels associated to presence of polymorphous allele. Conclusions: in present group of Cuban population the above mentioned polymorphous variants are not involved in etiology of type 2 diabetes mellitus.

  14. Quantitative Proteomic Analysis of Hepatic Tissue of T2DM Rhesus Macaque

    Directory of Open Access Journals (Sweden)

    Tingfu Du

    2017-01-01

    Full Text Available Type 2 diabetes mellitus (T2DM is a metabolic disorder that severely affects human health, but the pathogenesis of the disease remains unknown. The high-fat/high-sucrose diets combined with streptozotocin- (STZ- induced nonhuman primate animal model of diabetes are a valuable research source of T2DM. Here, we present a study of a STZ rhesus macaque model of T2DM that utilizes quantitative iTRAQ-based proteomic method. We compared the protein profiles in the liver of STZ-treated macaques as well as age-matched healthy controls. We identified 171 proteins differentially expressed in the STZ-treated groups, about 70 of which were documented as diabetes-related gene in previous studies. Pathway analyses indicated that the biological functions of differentially expressed proteins were related to glycolysis/gluconeogenesis, fatty acid metabolism, complements, and coagulation cascades. Expression change in tryptophan metabolism pathway was also found in this study which may be associations with diabetes. This study is the first to explore genome-wide protein expression in hepatic tissue of diabetes macaque model using HPLC-Q-TOF/MS technology. In addition to providing potential T2DM biomarkers, this quantitative proteomic study may also shed insights regarding the molecular pathogenesis of T2DM.

  15. Do eating behaviors in the general population account for country variance in glycemic control among adolescents with diabetes: the Hvidoere Study Group and the Health Behaviour in School-Aged Children study.

    Science.gov (United States)

    Due, Pernille; de Beaufort, Carine; Damsgaard, Mogens Trab; Mortensen, Henrik Bindesbøl; Rasmussen, Mette; Ahluwalia, Naman; Skinner, Timothy; Swift, Peter

    2013-12-01

    The Hvidoere Study Group (HSG) has demonstrated major differences in glycemic control between pediatric diabetes centers which remain largely unexplained. This study investigates whether these differences are partly attributable to healthy eating norms in the background population. The study involved adolescents from 18 countries from (i) the Health Behaviour in School-Aged Children study (HBSC) and (ii) the HSG. There were 94 387 participants from representative HBSC samples of 11-, 13- and 15-yr-olds and 1483 11- to 15-yr-old adolescents with diabetes from the HSG. The frequency of intake of fruit, vegetables, sweets, sugary soft drinks, and daily breakfast was compared between the two groups. The glycemic control of the adolescents in the HSG cohort was determined by measuring glycated hemoglobin (HbA1c). Across countries in the HSBC survey, there was substantial variation in prevalence of healthy eating behavior and even greater variation between adolescents from the HSG centers. In all countries more adolescents with diabetes reported healthy eating behavior compared to national norms. In individuals healthy eating behavior had a significant effect on the individual level HbA1c. There was no significant correlation between the frequencies of these healthy eating behaviors at (i) the national level and (ii) diabetes center level and the center mean HbA1c. Although individual healthy eating behavior is associated with better glycemic control at the individual level, such eating behavior does not explain the center differences in HbA1c. Similarly, the reported healthy eating norm of the background populations does not explain the variation in glycemic control among centers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Pesquisa do nistagmo/vertigem de posição e avaliação eletronistagmográfica em um grupo de indivíduos portadores de diabetes Mellitus tipo I Search of the nystagmus/ positional vertigo and electronystagmographic evaluation in a group of diabetics Mellitus type I

    Directory of Open Access Journals (Sweden)

    Lílian P. Scherer

    2002-05-01

    Full Text Available Introdução: De acordo com a Sociedade Brasileira de Diabetes, estima-se que existam no Brasil cerca de 5 milhões de pessoas com a patologia. No estado do Rio Grande do Sul há, provavelmente, 400.000 pacientes diabéticos23,27. Dentre as alterações que os indivíduos portadores de diabetes Mellitus podem apresentar, estão incluídos os distúrbios vestibulares. Objetivo: O presente trabalho teve por objetivo colaborar nas pesquisas de melhoria na qualidade de vida do paciente diabético e realizar pesquisa do nistagmo/ vertigem de posição e eletronistagmografia, a fim de identificar possíveis alterações. Forma de estudo: Clínico prospectivo. Material e método: 12 indivíduos portadores de diabetes Mellitus tipo I, usuários regulares de insulina, com idades entre 12 e 27 anos e componentes da Associação Riograndense de Apoio aos Diabéticos (ARAD. Para verificar as respostas vestibulares nos indivíduos portadores de diabetes Mellitus tipo I, foram realizados anamnese específica, meatoscopia, timpanometria, pesquisa do nistagmo/ vertigem de posição e eletronistagmografia na amostra selecionada. Resultados: Verificou-se Síndrome Vestibular Periférica Irritativa em 75% dos resultados alterados. Destes, 62,5% se tratavam de sujeitos sem queixa otoneurológica. Conclusões: Observou-se que o efeito do diabetes tipo I, na função vestibular, deve ser avaliado como as demais complicações diabéticas usuais, mesmo em pacientes assintomáticos, pois, com o diagnóstico etiológico precoce, é possível o auxílio na prevenção das complicações desta patologia.Introduction: According to the Brazilian Society of Diabetes, there are 5 million diabetics in Brazil. In the state of Rio Grande do Sul only, there are, probably, 400.000 diabetics23,27. This group of people can present vestibular alterations. Aim: This article had the objective to contribute with the searches to help improve the quality of life of the diabetics and to

  17. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: common genetic variants in GCK and TCF7L2 are associated with fasting and postchallenge glucose levels in pregnancy and with the new consensus definition of gestational diabetes mellitus from the International Association of Diabetes and Pregnancy Study Groups.

    Science.gov (United States)

    Freathy, Rachel M; Hayes, M Geoffrey; Urbanek, Margrit; Lowe, Lynn P; Lee, Hoon; Ackerman, Christine; Frayling, Timothy M; Cox, Nancy J; Dunger, David B; Dyer, Alan R; Hattersley, Andrew T; Metzger, Boyd E; Lowe, William L

    2010-10-01

    Common genetic variants in GCK and TCF7L2 are associated with higher fasting glucose and type 2 diabetes in nonpregnant populations. However, their associations with glucose levels from oral glucose tolerance tests (OGTTs) in pregnancy have not been assessed in a large sample. We hypothesized that these variants are associated with quantitative measures of glycemia in pregnancy. We analyzed the associations between variants rs1799884 (GCK) and rs7903146 (TCF7L2) and OGTT outcomes at 24-32 weeks' gestation in 3,811 mothers of European (U.K. and Australia) and 1,706 mothers of Asian (Thailand) ancestry from the HAPO cohort. We also tested associations with offspring birth anthropometrics. The maternal GCK variant was associated with higher fasting glucose in Europeans (P = 0.001) and Thais (P 0.05). In both populations, both variants were associated with higher odds of gestational diabetes mellitus according to the new International Association of Diabetes and Pregnancy Study Groups recommendations (P = 0.001-0.08). Maternal GCK and TCF7L2 variants are associated with glucose levels known to carry an increased risk of adverse pregnancy outcome in women without overt diabetes. Further studies will be important to determine the variance in maternal glucose explained by all known genetic variants.

  18. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  19. Diabetic Ketoacidosis

    Science.gov (United States)

    ... blood sugar level begins to rise, follow your diabetes treatment plan to return your blood sugar level to ... from taking good care of yourself. Follow your diabetes treatment plan carefully, and ask your diabetes treatment team ...

  20. Alogliptin as a third oral antidiabetic drug in patients with type 2 diabetes and inadequate glycaemic control on metformin and pioglitazone: a 52-week, randomized, double-blind, active-controlled, parallel-group study.

    Science.gov (United States)

    Bosi, E; Ellis, G C; Wilson, C A; Fleck, P R

    2011-12-01

    To assess the efficacy and safety of adding alogliptin versus uptitrating pioglitazone in patients with type 2 diabetes and inadequate glycaemic control on metformin and pioglitazone. In this randomized, double-blind, active-controlled, parallel-group study, patients with type 2 diabetes and A1c ≥7.0 and ≤10.0% on metformin (≥1500 mg or maximum tolerated dose; Met) and pioglitazone 30 mg (Pio30) received alogliptin 25 mg (Alo25; n = 404) or pioglitazone 15 mg (n = 399) added to Met+Pio30 for 52 weeks. The primary endpoint was change from baseline (CFB) in A1c at weeks 26 and 52, with sequential testing for non-inferiority of Met+Pio30+Alo25 at weeks 26 and 52 and then for superiority at week 52. Met+Pio30+Alo25 showed superior glycaemic control versus Met+Pio45 at week 52 [least squares (LS) mean CFB in A1c, -0.70 vs. -0.29%; p metformin-pioglitazone regimen provided superior glycaemic control and potentially improved β-cell function versus uptitrating pioglitazone in patients with type 2 diabetes, with no clinically important differences in safety. © 2011 Blackwell Publishing Ltd.

  1. Diabetic Neuropathy

    Science.gov (United States)

    ... SEARCH Definition Treatment Prognosis Clinical Trials Organizations Publications Definition Diabetic neuropathy is a peripheral nerve disorder caused by diabetes or poor blood sugar control. The most common ...

  2. Allegheny County Diabetes Hospitalization

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data includes the number of people hospitalized with diabetes between 2013-2015, by age group, for Allegheny County Zip Codes.

  3. Is diabetes always diabetes?

    Science.gov (United States)

    Akinmokun, A; Harris, P; Home, P D; Alberti, K G

    1992-11-01

    Diabetes is always taken to be a life-long diagnosis. In order to re-examine this question, 75 g glucose tolerance tests (OGTT) were performed twice on 37 previously confirmed diabetic patients (mean duration of diabetes of 4.6 years; range 1-15 years) with normal glycosylated haemoglobin levels on regular review. Weight loss since institution of a healthy diet was 7.6 +/- 4.8 kg (+/- SE). Normal glucose tolerance was found in 27% of patients and impaired glucose tolerance in 21% with no significant change on rechallenge. HbA1 was 6.3 +/- 1.5% (+/- SD) (normal definition of diabetes should be reviewed to allow people to escape the diagnosis where permanent change in dietary habits is established.

  4. Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie’s disease? Analysis in 279 patients with a control group in Sicily

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    Carlo Pavone

    2015-03-01

    Full Text Available Objective: To assess the proportion of patients with Peyronie’s Disease (PD and the possible association with its potential risk factors in the general population of the central and western Sicily in our weekly andrological outpatient clinic. Materials and methods: We recruited a sample of 279 consecutive patients consulting our andrological outpatient clinic. Two arms were created: the first one composed by PD patients (men with symptoms suggestive for PD, the second one composed by patients with other andrological diseases (control arm. For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function. In the PD arm we administered validated questionnaires to determine the erectile function status by the International Index of Erectile Function 5 (IIEF-5 and the pain status during erection by the Visual Analogue Scale (VAS. A univariate analysis was conducted using R software. Results: We enrolled 279 consecutive patients. The number of PD patients was 97 (34,7%. The univariate analysis showed a correlation between PD and cigarette smoking (p = 0.0242, blood hypertension (p < 0.001, erectile dysfunction (p < 0.001. No significant association was observed between diabetes and PD (p = 0.358. The median age of PD arm was 60 years and the median age of the control arm was 63,5 years; therefore the median age of PD arm resulted lower than the median age of the control arm (p = 0,031. Conclusions: Peyronie’s disease is more common than we might think; furthermore it can be diagnosed among young patients. According to our results, cigarette smoking and blood hypertension may be considered statically significant risk factors for developing PD. On the contrary diabetes seems not to be a risk factor for PD. According to our results PD should be sought also in young patients. Further studies are necessary to confirm that removing the indicated risk factors may reduce the incidence of PD.

  5. Other adaptations to training/inactivity in type 2 diabetics and other groups with insulin resistance: emphasis on prevention of CHD

    DEFF Research Database (Denmark)

    Dela, Flemming

    2007-01-01

    Physical training is recommended for the prevention and treatment of cardiovascular disease in the general population. In patients with type 2 diabetes this is even more important, because the risk of clinical atherosclerotic disease is 2- to 3-fold that of nondiabetics and the survival rate...... is poorer. However, increased daily physical activity (e.g., walking for exercise) has been shown to reduce the risk of premature death from all causes and from cardiovascular disease in particular. The mechanism for the positive effect of physical training may be a reduction of known risk factors...... for atherosclerosis, but a direct effect on the atherosclerotic process per se cannot be excluded....

  6. Epigenetic modification of miR-10a regulates renal damage by targeting CREB1 in type 2 diabetes mellitus.

    Science.gov (United States)

    Shan, Qun; Zheng, Guihong; Zhu, Aihua; Cao, Li; Lu, Jun; Wu, Dongmei; Zhang, ZiFeng; Fan, Shaohua; Sun, Chunhui; Hu, Bin; Zheng, Yuanlin

    2016-09-01

    Emerging evidence has shown that microRNA-mediated gene expression modulation plays a crucial role in the pathogenesis of type 2 diabetes mellitus, but the novel miRNAs involved in type 2 diabetes and its functional regulatory mechanisms still need to be determined. In this study, we assessed the role of miR-10a in extracellular matrix accumulation in the kidney of diabetic mellitus induced by combining administration of chronic high fat diet (HFD) and low dosage of streptozotocin (STZ, 35mg/kg). Here, we found that HFD/STZ administration decreased the level of microRNA (miR-10a) expression in ICR strain mice. Overexpression of miR-10a alleviated the increased ratio of urine albumin-to-creatinine (ACR) ratio of HFD/STZ mice. In contrast, knockdown of miR-10a increased the ratio of kidney ACR in naïve mice. Furthermore, cAMP response element binding protein 1 (CREB1) was validated as a target of miR-10a in vitro and in vivo. CREB1 and its downstream fibronectin (FN, extracellular matrix) were increased in HFD/STZ-treated mice, which was reversed by kidney miR-10a overexpression. The content of CREB1 and FN was increased by miR-10a knockdown in kidney of naïve mice. Furthermore, histone deacetylase 3 (HDAC3) was revealed to be increased in kidney of HFD/STZ mice, accompanied with the augmentation of ACR ratio and FN level. Knockdown of HDAC3 with siRNA significantly caused the increase of miR-10a, resulting in the decrease in CREB1 and FN expression in kidney of HFD/STZ mice. Contrarily, HDAC3 overexpression mediated by lentivirus decreased miR-10a content, and enhanced ACR value, CREB1 and FN formation in naïve mice. Collectively, these results elucidate that HDAC3/miR-10a/CREB1 serves as a new mechanism underlying kidney injury, providing potential therapeutic targets in type 2 diabetes. Copyright © 2016. Published by Elsevier Inc.

  7. Diabetes Care in India.

    Science.gov (United States)

    Joshi, Shashank R

    2015-01-01

    Diabetes has become a major health care problem in India with an estimated 66.8 million people suffering from the condition, representing the largest number of any country in the world. The rising burden of diabetes has greatly affected the health care sector and economy in India. The goal of health care experts in India is to transform India into a diabetes care capital in the world. An expert detailed review of the medical literature with an Asian Indian context was performed. Recent epidemiologic studies from India point to a great burden from diabetes. Diabetes control in India is far from ideal with a mean hemoglobin A1c of 9.0%-at least 2.0% higher than suggested by international bodies. Nearly half of people with diabetes remain undetected, accounting for complications at the time of diagnosis. Screening can differentiate an asymptomatic individual at high risk from one at low risk for diabetes. Despite the large number of people with diabetes in India, awareness is low and needs to be addressed. Other challenges include balancing the need for glycemic control with risk reduction due to overly tight control, especially in high-risk groups and taking into account health care professional expertise, attitudes, and perceptions. Pharmacologic care should be individualized with early consideration of combination therapy. Regular exercise, yoga, mindful eating, and stress management form a cornerstone in the management of diabetes. Considering the high cost incurred at various steps of screening, diagnosis, monitoring, and management, it is important to realize the cost-effective measures of diabetes care that are necessary to implement. Result-oriented organized programs involving patient education, as well as updating the medical fraternity on various developments in the management of diabetes, are required to combat the current diabetes epidemic in India. Copyright © 2015. Published by Elsevier Inc.

  8. The relative incidence of diabetes mellitus in abo/rhesus blood ...

    African Journals Online (AJOL)

    A total of 224 diabetics and 221 non-diabetics (control) were involved in this study, to determine the relative incidence of diabetes mellitus in ABO/Rhesus blood group. The current criteria for the diagnosis f diabetes mellitus were applied in differentiating the diabetics from the non-diabetics. Blood group, fasting blood sugar ...

  9. Diabetes and Foot Problems

    Science.gov (United States)

    ... Damage (Diabetic Neuropathies) Diabetic Kidney Disease Diabetes and Foot Problems Diabetic Eye Disease Diabetes, Gum Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes and Foot Problems Foot problems are common in people with ...

  10. Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"

    Directory of Open Access Journals (Sweden)

    2013-08-01

    Full Text Available There are many studies on the prevalence, clinical characteristics, and economic burden of diabetes across the past four decades in Korea. Nonetheless, there is a dearth of nationwide study regarding diabetes encompassing all age group. Eight years ago, the Committee on the Epidemiology of Diabetes Mellitus of Korean Diabetes Association collaborated with Health Insurance Review & Assessment Service to evaluate the status of diabetes care and characteristics in diabetic patients in Korea. In 2007, the collaborative task force team published a comprehensive survey titled "Diabetes in Korea 2007." In this review, we reappraise the diabetic epidemics from the joint report and suggest further studies that are needed to be investigated in the future.

  11. [Diabetic neuropathy].

    Science.gov (United States)

    Lechleitner, Monika; Abrahamian, Heidemarie; Francesconi, Claudia; Kofler, Markus

    2016-04-01

    These are the guidelines for diagnosis and treatment of diabetic neuropathy. This diabetic late complication comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy. The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided.

  12. Diabetes Medicines

    Science.gov (United States)

    ... to metabolic surgery: looking for a “disease modifier” surgery for type 2 diabetes. World Journal of Diabetes. 2016;7(2):27–33. [2] Kirwan JP, Aminian A, Kashyap SR, Burguera B, Brethauer SA, Schauer PR. Bariatric surgery in obese patients with type 1 diabetes. Diabetes ...

  13. diabetic patients

    Directory of Open Access Journals (Sweden)

    Mehraban Falahati

    2016-09-01

    candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8, and acidic urine pH (P<0.05. Conclusion: Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

  14. Lobeglitazone and pioglitazone as add-ons to metformin for patients with type 2 diabetes: a 24-week, multicentre, randomized, double-blind, parallel-group, active-controlled, phase III clinical trial with a 28-week extension.

    Science.gov (United States)

    Jin, S-M; Park, C-Y; Cho, Y M; Ku, B J; Ahn, C W; Cha, B-S; Min, K W; Sung, Y A; Baik, S H; Lee, K W; Yoon, K-H; Lee, M-K; Park, S W

    2015-06-01

    We aimed to compare the efficacy and safety of lobeglitazone and pioglitazone as add-ons to metformin in patients with type 2 diabetes. Patients who were inadequately controlled by metformin were randomized and treated once daily with either lobeglitazone (0.5 mg, n = 128) or pioglitazone (15 mg, n = 125) for 24 weeks, with a 28-week extension trial of lobeglitazone treatment in patients who consented. The primary endpoint was the change in glycated haemoglobin (HbA1c) concentration from baseline to week 24. At week 24, the mean change from baseline in HbA1c was -0.74% for the lobeglitazone group and -0.74% for the pioglitazone group, with a mean difference of 0.01% [95% confidence interval (CI) of difference, -0.16 to 0.18]. The effects of lobeglitazone on lipid variables and the adverse events associated with lobeglitazone were similar to those observed with pioglitazone. Lobeglitazone was not inferior to pioglitazone as an add-on to metformin in terms of their efficacy and safety. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  15. Recovery from diabetes in neonatal mice after a low-dose streptozotocin treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kataoka, Masateru; Kawamuro, Yuki; Shiraki, Nobuaki [Department of Stem Cell Biology, Institute of Molecular Embryology and Genetics (IMEG), Kumamoto University, Honjo 2-2-1, Chuo-ku, Kumamoto 860-0811 (Japan); Miki, Rika; Sakano, Daisuke [Department of Stem Cell Biology, Institute of Molecular Embryology and Genetics (IMEG), Kumamoto University, Honjo 2-2-1, Chuo-ku, Kumamoto 860-0811 (Japan); The Global COE Cell Fate Regulation Research and Education Unit, Kumamoto University, Honjo 2-2-1, Chuo-ku, Kumamoto 860-0811 (Japan); Yoshida, Tetsu; Yasukawa, Takanori; Kume, Kazuhiko [Department of Stem Cell Biology, Institute of Molecular Embryology and Genetics (IMEG), Kumamoto University, Honjo 2-2-1, Chuo-ku, Kumamoto 860-0811 (Japan); Kume, Shoen, E-mail: skume@kumamoto-u.ac.jp [Department of Stem Cell Biology, Institute of Molecular Embryology and Genetics (IMEG), Kumamoto University, Honjo 2-2-1, Chuo-ku, Kumamoto 860-0811 (Japan); The Global COE Cell Fate Regulation Research and Education Unit, Kumamoto University, Honjo 2-2-1, Chuo-ku, Kumamoto 860-0811 (Japan)

    2013-01-18

    Highlights: ► We monitored long-term beta cell regeneration in neonatal mice treated with low dose STZ. ► Low-dose STZ neonatal female mice recovered blood glucose in 150 days. ► Glucose intolerance of the STZ treated mice significantly improved in 150 days. -- Abstract: Administration of streptozotocin (STZ) induces destruction of β-cells and is widely used as an experimental animal model of type I diabetes. In neonatal rat, after low-doses of STZ-mediated destruction of β-cells, β-cells regeneration occurs and reversal of hyperglycemia was observed. However, in neonatal mice, β-cell regeneration seems to occur much slowly compared to that observed in the rat. Here, we described the time dependent quantitative changes in β-cell mass during a spontaneous slow recovery of diabetes induced in a low-dose STZ mice model. We then investigated the underlying mechanisms and analyzed the cell source for the recovery of β-cells. We showed here that postnatal day 7 (P7) female mice treated with 50 mg/kg STZ underwent the destruction of a large proportion of β-cells and developed hyperglycemia. The blood glucose increased gradually and reached a peak level at 500 mg/dl on day 35–50. This was followed by a spontaneous regeneration of β-cells. A reversal of non-fasting blood glucose to the control value was observed within 150 days. However, the mice still showed impaired glucose tolerance on day 150 and day 220, although a significant improvement was observed on day 150. Quantification of the β-cell mass revealed that the β-cell mass increased significantly between day 100 and day 150. On day 150 and day 220, the β-cell mass was approximately 23% and 48.5% of the control, respectively. Of the insulin-positive cells, 10% turned out to be PCNA-positive proliferating cells. Our results demonstrated that, β-cell duplication is one of the cell sources for β-cell regeneration.

  16. Apolipoprotein(a) in insulin-dependent diabetic patients with and without diabetic nephropathy

    DEFF Research Database (Denmark)

    Gall, M A; Rossing, P; Hommel, E

    1992-01-01

    Insulin-dependent diabetic patients with diabetic nephropathy have a highly increased morbidity and mortality from cardiovascular diseases. To determine whether altered levels of apolipoprotein(a) (apo(a)), the glycoprotein of the potentially atherogenic lipoprotein(a) (Lp(a)), contribute...... to the increased risk of ischaemic heart disease, apo(a) was determined in 50 insulin-dependent diabetic patients with diabetic nephropathy (group 1), in 50 insulin-dependent diabetic patients with microalbuminuria (group 2), in 50 insulin-dependent diabetic patients with normoalbuminuria (group 3), and in 50...... healthy subjects (group 4). The groups were matched with regard to sex, age and body mass index. The diabetic groups were also matched with regard to diabetes duration. The level of apo(a) was approximately the same in the four groups, being: 122 (x/ divided by 4.2) U l-1, 63 (x/ divided by 4.4) U l-1...

  17. Safety and efficacy of inhaled insulin (AERx iDMS) compared with subcutaneous insulin therapy in patients with Type 1 diabetes: 1-year data from a randomized, parallel group trial.

    Science.gov (United States)

    Moses, R G; Bartley, P; Lunt, H; O'Brien, R C; Donnelly, T; Gall, M-A; Vesterager, A; Wollmer, P; Roberts, A

    2009-03-01

    Assessment of the long-term safety and efficacy of liquid inhaled insulin via AERx insulin Diabetes Management System (iDMS) in a basal/bolus treatment regimen of adults with Type 1 diabetes. Patients were randomized 2 : 1 to prandial inhaled (n = 205) or subcutaneous (s.c.) (n = 99) insulin, plus one/two daily injections of neutral protamine Hagedorn (NPH) insulin for 12 months. The primary endpoints were pulmonary function tests (PFT) and baseline changes in chest X-rays at 12 months. Safety and efficacy assessments were measured at regular intervals. PFTs after 12 months were comparable between the groups, except for reduced per cent of predicted carbon monoxide lung diffusing capacity with inhaled insulin (difference: -2.03%, P = 0.04) occurring after the first 3 months and then stabilizing. There were no apparent treatment differences in chest X-rays. Overall risk of hypoglycaemia [risk ratio (RR) 1.02, P = 0.83] and adverse events were comparable between groups. Risk of nocturnal hypoglycaemia was higher in the inhaled group (RR 1.58, P = 0.001). Cough [10% (inhaled); 3% (s.c.)] tended to be mild in nature. Inhaled insulin was non-inferior to s.c. insulin for change in glycated haemoglobin (HbA(1c)) after 12 months [difference 0.18% (CI 95%-0.04; 0.39)]. At trial end, mean laboratory measured fasting plasma glucose was lower in the inhaled group (inhaled 9.2 mmol/l; s.c. 11.7 mmol/l; difference: -2.53 mmol/l, P iDMS requires further optimization to reduce nocturnal hypoglycaemia before it has comparable safety and efficacy to s.c. insulin aspart.

  18. Two-year follow-up study of a group-based diabetes medical nutrition therapy and motivational interviewing intervention among African American women

    Directory of Open Access Journals (Sweden)

    Miller ST

    2017-04-01

    Full Text Available Stephania T Miller,1 Sylvie A Akohoue2 1Department of Surgery, 2Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA Objectives: To assess the 2-year efficacy of a combined medical nutrition therapy and motivational interviewing (MI pilot study intervention and factors that influenced long-term dietary self-care.Research design and methods: Pilot study participants, African American women with type 2 diabetes, completed a 2-year follow-up study visit, including clinical assessments and completion of a dietary self-care questionnaire and a semi-structured interview. Wilcoxon signed-rank tests were used to evaluate differences between baseline and 2-year follow-up clinical and dietary self-care outcomes. Hierarchical coding was used to analyze semi-structured interviews and categorize facilitator and barrier themes into subthemes. Subthemes were quantified based on the number of subtheme-related comments. Results: Among the 12 participants (mean age 57.1±5.7 years, improvements were observed for HbA1c (baseline: 10.25%; interquartile range [IQR]: 8.10, 11.72 and follow-up: 8.8%; IQR: 7.48,10.22, systolic blood pressure (baseline: 142 mm Hg; IQR: 134.25, 157.25 and follow-up: 127 mm Hg; IQR: 113.5, 143.25, frequency of eating high-fat foods (baseline: 3.5 days; IQR: 2.75, 4.25 and follow-up: 3 days; IQR: 2.5, 4.5, and of spacing carbohydrates throughout the day (baseline: 3 days; IQR: 3.0, 4.0 and follow-up: 4 days; IQR: 1.5, 4.5. There was a statistically significant decrease (p=0.04 in the frequency of fruit and vegetable intake (baseline: 4 days; IQR: 3.75, 7.0 and follow-up: 3.5 days; IQR: 2.75, 4.0. Dietary self-care barriers and facilitators included internal (eg, motivation and external factors (eg, social support. Motivation (70 comments and lack of motivation (67 comments were the most pervasive facilitator and barrier subthemes, respectively. Conclusion: Overall, diabetes-related clinical and dietary

  19. Pharmacodynamic analysis of the analgesic effect of capsaicin 8% patch (QutenzaTM in diabetic neuropathic pain patients: detection of distinct response groups

    Directory of Open Access Journals (Sweden)

    Martini C

    2012-03-01

    Full Text Available Christian Martini1,*, Ashraf Yassen2,*, Erik Olofsen1, Paul Passier2, Malcom Stoker3, Albert Dahan1 1Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands; 2Global Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development Europe, Leiderdorp, The Netherlands; 3Global Medical Sciences, Astellas Pharma Global Development Europe, Leiderdorp, The Netherlands*These authors contributed equally to this workAbstract: Treatment of chronic pain is associated with high variability in the response to pharmacological interventions. A mathematical pharmacodynamic model was developed to quantify the magnitude and onset/offset times of effect of a single capsaicin 8% patch application in the treatment of painful diabetic peripheral neuropathy in 91 patients. In addition, a mixture model was applied to objectively match patterns in pain-associated behavior. The model identified four distinct subgroups that responded differently to treatment: 3.3% of patients (subgroup 1 showed worsening of pain; 31% (subgroup 2 showed no change; 32% (subgroup 3 showed a quick reduction in pain that reached a nadir in week 3, followed by a slow return towards baseline (16% ± 6% pain reduction in week 12; 34% (subgroup 4 showed a quick reduction in pain that persisted (70% ± 5% reduction in week 12. The estimate of the response-onset rate constant, obtained for subgroups 1, 3, and 4, was 0.76 ± 0.12 week-1 (median ± SE, indicating that every 0.91 weeks the pain score reduces or increases by 50% relative to the score of the previous week (= t½. The response-offset rate constant could be determined for subgroup 3 only and was 0.09 ± 0.04 week-1 (t½ 7.8 weeks. The analysis allowed separation of a heterogeneous neuropathic pain population into four homogenous subgroups with distinct behaviors in response to treatment with capsaicin. It is argued that this model-based approach may have added value in analyzing

  20. [Diabetes mellitus].

    Science.gov (United States)

    Ahdi, M; Gerdes, V E A; Hoekstra, J B L; Meesters, E W

    2012-02-01

    Currently there are over 740,000 patients with diabetes mellitus in the Netherlands, and this number will increase further in the coming years. Approximately 90% of patients has type 2 diabetes, a metabolic disorder that is often associated with obesity, hypertension and increased cholesterol levels. Treatment of diabetes mellitus is essential to reduce the risk of severe complications with irreversible organ damage in the long-term. Gingivitis and periodontitis are more common in patients with diabetes mellitus and are now also considered as complications of diabetes. Collaboration among healthcare professionals is important for effective diabetes care.

  1. Relation of retinopathy in patients with type 2 diabetes mellitus to other diabetic complications

    Directory of Open Access Journals (Sweden)

    Shu-Hui Chen

    2016-02-01

    Full Text Available AIM: To investigate the correlation between systemic complications and diabetic retinopathy in the patients with type 2 diabetes mellitus.METHODS: Seven hundred and two hospitalized patients with type 2 diabetes were included. All patients were divided into two groups according to with or without retinopathy: NDR group and DR group. DR group was divided into group non-proliferative diabetic retinopathy(NPDRand group proliferative diabetic retinopathy(PDR. The relation between DR and other complications of diabetes, including diabetic macrovascular complications, diabetic nephropathy(DN, diabetic peripheral neuropathy(DPN, peripheral vascular disease of diabetes mellitus(PVD, diabetic foot(DF, diabetic ketoacidosis(DKA, was analyzed.RESULTS: The development of DR was related to hypertension, hyperlipemia, carotid atherosclerosis and plaque, lower extremity arteriosclerosis and plaque, DN, DPN, DF and PVD. PDR was closely associated with hypertension and DPN. CONCLUSION: The prevalence of DR increased in the diabetic patients with systemic complications, especially, the increase of prevalence of PDR in the patients with hypertension and DPN. Vascular endothelial injury and microcirculatory disturbance are the common pathologic base for DR and other complications. Therefore, it is important to carry out the regular fundus examination in the diabetic patients, especially in those with systemic complication, in order to decrease the rate of blindness.

  2. "Smile healthy to your diabetes"

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak; Oktay, Inci; Schou, Lone

    2014-01-01

    OBJECTIVES: This study is the first to our knowledge that aims to evaluate the impact of Health Coaching (HC) compared to Health Education (HE) on oral health and diabetes management among patients with diabetes type II (DM2). MATERIAL AND METHODS: The study is part of a prospective intervention ......, physicians, and diabetes educators in order to improve quality of life of DM2 patients by facilitating better oral health and diabetes self-management.......OBJECTIVES: This study is the first to our knowledge that aims to evaluate the impact of Health Coaching (HC) compared to Health Education (HE) on oral health and diabetes management among patients with diabetes type II (DM2). MATERIAL AND METHODS: The study is part of a prospective intervention...... to postintervention had significant impact on reduced HbA1c in the HC group (p diabetes and oral health when compared to formal HE. This calls for the use of HC by dentists...

  3. [Changes of the conjunctival nervous fillets in diabetic patients].

    Science.gov (United States)

    Ignat, Florica; Niculescu, Mihaela; Mănescu, Rodica

    2004-01-01

    Our study suggested to reveal nervous fillets changes from conjunctiva structure in patients with diabetes. We removed bulbar conjunctiva during cataract surgery on diabetic and non-diabetic patients from the same age group. The conjunctiva fragments were fixed in Lillie's solution, then studied by using optical microscopy with usual and histochemical stainings. Nervous fillets just like perinervium are better represented in younger diabetic patients without diabetic retinopathy or with early diabetic retinopathy and non-diabetic patients, too. In older patients and old diabetes, nervous fillets are much less in number with poor represented perinervium. Significant changes of the conjunctiva nervous fillets were found in patients with long-term diabetes.

  4. Diabetes autoantibodies do not predict progression to diabetes in adults: the Diabetes Prevention Program.

    Science.gov (United States)

    Dabelea, D; Ma, Y; Knowler, W C; Marcovina, S; Saudek, C D; Arakaki, R; White, N H; Kahn, S E; Orchard, T J; Goldberg, R; Palmer, J; Hamman, R F

    2014-09-01

    To determine if the presence of diabetes autoantibodies predicts the development of diabetes among participants in the Diabetes Prevention Program. A total of 3050 participants were randomized into three treatment groups: intensive lifestyle intervention, metformin and placebo. Glutamic acid decarboxylase (GAD) 65 autoantibodies and insulinoma-associated-2 autoantibodies were measured at baseline and participants were followed for 3.2 years for the development of diabetes. The overall prevalence of GAD autoantibodies was 4.0%, and it varied across racial/ethnic groups from 2.4% among Asian-Pacific Islanders to 7.0% among non-Hispanic black people. There were no significant differences in BMI or metabolic variables (glucose, insulin, HbA(1c), estimated insulin resistance, corrected insulin response) stratified by baseline GAD antibody status. GAD autoantibody positivity did not predict diabetes overall (adjusted hazard ratio 0.98; 95% CI 0.56-1.73) or in any of the three treatment groups. Insulinoma-associated-2 autoantibodies were positive in only one participant (0.033%). These data suggest that 'diabetes autoimmunity', as reflected by GAD antibodies and insulinoma-associated-2 autoantibodies, in middle-aged individuals at risk for diabetes is not a clinically relevant risk factor for progression to diabetes. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  5. Problemas sociales referidos por un grupo de personas atendidas en el Centro de Atención al Diabético Social problems referred to by a group of persons receiving attention at the Diabetic Care Center

    Directory of Open Access Journals (Sweden)

    Marlene García Castro

    2005-08-01

    actividad laboral. La familia se constituye en una fuente de apoyo para la persona con diabetes; sin embargo, uno de los problemas encontrados en nuestro estudio fue la falta de comprensión hacia la enfermedad por parte de la familia.The non-communicable chronic disease is a phenomenon that occupies an important place in the health situation of the world population, affects the quality of life of the individual and influences on the somatic, psychological and social aspects. Diabetes mellitus is an example par excellence of this situation, whose interference may comprises aspects of the family, student, working, economic and social life. The National Institute of Endocrinology (INEN, in Spanish has dealth with these problems since it was founded giving attention to the persons with diabetes by a comprehensive and interdisciplinary approach, where the social work is the link between the health team, the person and his social daily setting The objective of this paper was to determine the social problems referred to by a group of persons with diabetes admitted in the Day Center Service of the National Institute of Endocrinology in the last quarter of 2003. The method used consisted in an exploratory study. 189 individuals that received attention at the Diabetic Care Centre from October to December 2003, were surveyed. As a result, 81 (43 % social problems were presented. The main problem was found in the working aspects (80, accounting for 98 %. They were connected with non-related jobs, difficulties to keep the diet or to follow the medical indications at work and during the shifts. 57.3 % had economic problems, which were associated with difficulties to get food and drugs on their own. 16 % had family problems that influenced on the generational relations, interference of the disease in the family dynamics and lack of concern of the family. It was concluded that the fundamental social problems observed in the group were the working ones, which were related to difficulties

  6. Diabetes and the menopause.

    Science.gov (United States)

    Khoo, Cheen Leen; Perera, Mahesh

    2005-03-01

    As life expectancy increases, women are spending more time in the postmenopausal phase of life. Diabetes is one of the most common chronic diseases in the world and its prevalence is increasing. Type 2 diabetes mellitus is more common than type 1 (it accounts for 90% of all cases) and is most frequent in obese individuals over the age of 40 years. In this review, the main problems faced by postmenopausal diabetic women are examined, and hormone replacement therapy (HRT) in this group of women is discussed. HRT appears to decrease the incidence of type 2 diabetes mellitus and to improve glycaemic control; the results vary according to the type of HRT and the route of administration. HRT also improves lipid profiles and transdermal delivery seems to decrease triglyceride levels in particular. There are conflicting data on the effect of HRT on coronary heart disease (CHD); however, it may be beneficial in younger postmenopausal diabetic women. Cardioprotective treatment adjuncts (such as statins or low-dose aspirin) may be advised in diabetic women with CHD risk factors who require HRT. However, their prescription is currently not recommended solely for the possible prevention of cardiovascular disease. HRT may also protect women from osteoporosis in diabetes, especially in type 1 diabetes mellitus. It is recommended that the lowest possible effective dose is used. In postmenopausal diabetic women in whom HRT is not suitable, alternatives such as bisphosphonates may be employed. In these women, vasomotor symptoms can also be improved using drugs such as venlafaxine or gabapentin. Based on current data, we have proposed a regimen that could be used for women with diabetes.

  7. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  8. Diabetic Pets

    Science.gov (United States)

    ... health or management, contact your veterinarian. In addition, diabetic pets should be monitored for long-term complications such as cataracts, which commonly develop in diabetic dogs and cats. Other problems that can occur ...

  9. Diabetes Insipidus

    Science.gov (United States)

    Diabetes insipidus (DI) causes frequent urination. You become extremely thirsty, so you drink. Then you urinate. This ... is almost all water. DI is different from diabetes mellitus (DM), which involves insulin problems and high ...

  10. Diabetes Myths

    Science.gov (United States)

    ... Text Size: A A A Listen En Español Diabetes Myths On behalf of the millions of Americans ... or obese, you will eventually develop type 2 diabetes. Fact: Being overweight is a risk factor for ...

  11. Diabetes Complications

    Science.gov (United States)

    If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can cause problems with other body ... as your kidneys, nerves, feet, and eyes. Having diabetes can also put you at a higher risk ...

  12. Diabetic Foot

    National Research Council Canada - National Science Library

    Lepantalo, M; Apelqvist, Jan; Setacci, C; Ricco, J. -B; de Donato, G; Becker, F; Robert-Ebadi, H; Cao, P; Eckstein, H. H; De Rango, P; Diehm, N; Schmidli, J; Teraa, M; Moll, F. L; Dick, F; Davies, A. H

    2011-01-01

    Ulcerated diabetic foot is a complex problem. Ischaemia, neuropathy and infection are the three pathological components that lead to diabetic foot complications, and they frequently occur together as an aetiologic triad...

  13. A prospective, parallel group, open-labeled, comparative, multi-centric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetes.

    Science.gov (United States)

    Jayaram, S; Hariharan, R S; Madhavan, R; Periyandavar, I; Samra, S S

    2010-11-01

    The present study was a prospective, parallel group, open-labeled, comparative, multicentric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetic patients. A total of 229 patients with type 2 diabetes were enrolled at 5 medical centers across India. They received either acarbose (50 mg) + metformin (500 mg) bid/tid (n=115) or metformin monotherapy (500 mg) bid/ tid (n=114) for 12 weeks. Primary objective was to evaluate safety and tolerability based on the adverse events reported. Secondary objective was efficacy assessment based on changes in fasting, post prandial blood glucose and HbA1c values. In the acarbose + metformin group 10 patients reported 14 adverse events while in metformin group 9 patients reported 10 adverse events. No patient reported any serious adverse event or was withdraw from study because of adverse events. In the acarbose plus metformin group fasting blood glucose (FBG) decreased from a baseline of 158.85 +/- 18.14 mg/dl to 113.55 +/- 19.38 mg/dl (p fasting blood glucose decreased from a baseline of 158.31 +/- 26.53 mg/dl to 130.55 +/- 28.31 mg/dl (p < 0.0001) (decrease of 27.76 +/- 22.91 mg/dl) at 12 weeks. In the acarbose plus metformin group postprandial blood glucose (PPBG) decreased from a baseline of 264.65 +/- 34.03 mg/dl to 173.22 +/- 31.40 mg/dl (p < 0.0001) (decrease of 91.43 +/- 28.65 mg/dl) at 12 weeks, while in the metformin group PPBG decreased from a baseline of 253.56 +/- 36.28 mg/dl to 205.36 +/- 39.49 mg/dl (p < 0.0001) (decrease of 48.20 +/- 32.72 mg/dl) at 12 weeks. In the acarbose plus metformin group glycosylated haemoglobin (HbA1c) decreased from a baseline of 9.47 +/- 0.69% to 7.71 +/- 0.85% (p < 0.0001) (% decrease of 1.76 +/- 1.11) at 12 weeks, while in the metformin group HbAlc decreased from a baseline of 9.32 +/- 0.65% to 8.26 +/- 0.68% (p < 0.0001) (% decrease of 1.06 +/- 0.66) at 12 weeks. The

  14. Women and Diabetes

    Medline Plus

    Full Text Available ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  15. Diabetes Research Institute Foundation

    Science.gov (United States)

    ... Caring for Older People with Diabetes Checking Blood Sugar Diabetes at School Exercise and Diabetes Explaining Diabetes to ... Insulin Therapy Keeping Your Heart Healthy Low Blood Sugar Meal Planning Preventing Diabetes Complications Preventing Type 2 Diabetes Setting Goals Sick ...

  16. Serum lipids and diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Shoja MR

    2007-05-01

    Full Text Available Background: Diabetes Mellitus is the most common endocrinologic disease in human and retinopathy is one of the most common complications. Etiology of this complication is yet unknown but one of the factors that can be effective on its production or progression is serum lipid. We aim to study the relationship between different degrees of diabetic retinopathy and serum lipids levels. Methods: An observational cross-sectional study designed to study over 37 patients with diabetes mellitus type one and 157 patients with diabetes mellitus type two. Former was selected as sensus and latter was selected randomly from diabetic patients attending the diabetes clinic in Yazd during 2002. Inclusion criteria was duration of diabetes at least seven years from diagnosis. Statistical analysis performed by SPSS package edition 11 and wit statistical tests as Chi square, Fisher Exact and ANOVA. Results: Among 194 cases, 74 cases were males and 120 females. 90 cases (46.4% have normal total serum cholesterol and 104 (53.6% hypercholestrolemia. In case of triglyceride 94 cases (48.4% have normal serum triglyceride and 100 (51.6% hypertriglyceridemia. Distribution of different degrees of diabetic retinopathy was statistically significant due to cholesterol and triglycerides (P-Value<0.05. In different groups of sex, diabetic retinopathy was more prevalent if there was hypertriglyceridemia or hypercholesterolemia. This was correct about different groups of age and type of diabetes. This means that in different groups of age and type of diabetes, diabetic retinopathy was more prevalent if there was hypertriglyceridemia or hypercholesterolemia. Conclusion: Prevalence of diabetic retinopathy is higher in cases with hypertriglyceridemia or hypercholesterolemia than cases with normal serum triglyceride or cholesterole.

  17. Diabetic nephropathy

    DEFF Research Database (Denmark)

    Rossing, Peter

    2006-01-01

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

  18. Hyperglycemia Promotes the Epithelial-Mesenchymal Transition of Pancreatic Cancer via Hydrogen Peroxide

    Directory of Open Access Journals (Sweden)

    Wei Li

    2016-01-01

    Full Text Available Diabetes mellitus (DM and pancreatic cancer are intimately related, as approximately 85% of patients diagnosed with pancreatic cancer have impaired glucose tolerance or even DM. Our previous studies have indicated that high glucose could promote the invasive and migratory abilities of pancreatic cancer cells. We therefore explored the underlying mechanism that hyperglycemia modulates the metastatic potential of pancreatic cancer. Our data showed that streptozotocin- (STZ- treated diabetic nude mice exhibit larger tumor size than that of the euglycemic mice. The number of nude mice that develop liver metastasis or ascites is much more in the STZ-treated group than that in the euglycemic group. Hyperglycemic mice contain a higher plasma H2O2-level than that from euglycemic mice. The injection of polyethylene glycol-conjugated catalase (PEG-CAT, an H2O2 scavenger, may reverse hyperglycemia-induced tumor metastasis. In addition, hyperglycemia could also modulate the expression of epithelial-mesenchymal transition- (EMT- related factors in pancreatic tumor tissues, as the E-cadherin level is decreased and the expression of mesenchymal markers N-cadherin and vimentin as well as transcription factor snail is strongly increased. The injection of PEG-CAT could also reverse hyperglycemia-induced EMT. These results suggest that the association between hyperglycemia and poor prognosis of pancreatic cancer can be attributed to the alterations of EMT through the production of hydrogen peroxide.

  19. NorLeu3-A(1-7) stimulation of diabetic foot ulcer healing: results of a randomized, parallel-group, double-blind, placebo-controlled phase 2 clinical trial.

    Science.gov (United States)

    Balingit, Peter P; Armstrong, David G; Reyzelman, Alexander M; Bolton, Laura; Verco, Shelagh J; Rodgers, Kathleen E; Nigh, Katherine A; diZerega, Gere S

    2012-01-01

    This randomized, double-blind, placebo-controlled Phase 2 clinical trial explored NorLeu(3)-A(1-7) (DSC127) safety and healing efficacy in diabetic foot ulcers. Patients with chronic, noninfected, neuropathic, or neuroischemic plantar Wagner Grade 1 or 2 foot ulcers (n = 172) were screened for nonhealing. Subjects were randomized to receive 4 weeks' once-daily topical treatment with 0.03% DSC127 (n = 26), 0.01% DSC127 (n = 27), or Placebo (n = 24), followed by 20 weeks' standard of care. DSC127 was assessed for safety (including laboratory values and adverse events), primary efficacy (% ulcers completely epithelialized at Week 12), and durability of effect. Baseline, demography, and safety parameters were compared between intent-to-treat groups and were comparable. Dose-response curves for DSC127 effect on % area reduction from baseline at Week 12 (40% placebo; 67% 0.01% DSC127; 80% 0.03% DSC127) and 24 (23% placebo; 53% 0.01% DSC127; 95% 0.03% DSC127) followed a log-linear pattern for both intent-to-treat and per-protocol populations. Covariate analysis compared reduction in ulcer area, depth, and volume from baseline; reductions in the 0.03% DSC127 group were greater at Weeks 12 and 24. Placebo-treated ulcers healed in a median 22 weeks vs. 8.5 weeks for 0.03%DSC127 (p = 0.04). This study provides preliminary evidence that DSC127 is safe and effective in accelerating the healing of diabetic foot ulcers. © 2012 by the Wound Healing Society.

  20. Biomarkers of Diabetic Retinopathy.

    Science.gov (United States)

    Ting, Daniel Shu Wei; Tan, Kara-Anne; Phua, Val; Tan, Gavin Siew Wei; Wong, Chee Wai; Wong, Tien Yin

    2016-12-01

    Diabetic retinopathy (DR), a leading cause of acquired vision loss, is a microvascular complication of diabetes. While traditional risk factors for diabetic retinopathy including longer duration of diabetes, poor blood glucose control, and dyslipidemia are helpful in stratifying patient's risk for developing retinopathy, many patients without these traditional risk factors develop DR; furthermore, there are persons with long diabetes duration who do not develop DR. Thus, identifying biomarkers to predict DR or to determine therapeutic response is important. A biomarker can be defined as a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. Incorporation of biomarkers into risk stratification of persons with diabetes would likely aid in early diagnosis and guide treatment methods for those with DR or with worsening DR. Systemic biomarkers of DR include serum measures including genomic, proteomic, and metabolomics biomarkers. Ocular biomarkers including tears and vitreous and retinal vascular structural changes have also been studied extensively to prognosticate the risk of DR development. The current studies on biomarkers are limited by the need for larger sample sizes, cross-validation in different populations and ethnic groups, and time-efficient and cost-effective analytical techniques. Future research is important to explore novel DR biomarkers that are non-invasive, rapid, economical, and accurate to help reduce the incidence and progression of DR in people with diabetes.

  1. A new tool, a better tool? Prevalence and performance of the International Diabetes Federation and the National Cholesterol Education Program criteria for metabolic syndrome in different ethnic groups

    NARCIS (Netherlands)

    Bindraban, N. R.; van Valkengoed, I. G. M.; Mairuhu, G.; Koster, R. W.; Holleman, F.; Hoekstra, J. B. L.; Koopmans, R. P.; Stronks, K.

    2008-01-01

    We used a population based study in the Netherlands of 330 Hindustani Surinamese, 586 African Surinamese, and 486 ethnic Dutch (Dutch) to describe the prevalence of the metabolic syndrome (MS) and the association with differences in cardiovascular disease in and between ethnic groups. Fasting blood

  2. Diabetes insipidus - nephrogenic

    Science.gov (United States)

    Nephrogenic diabetes insipidus; Acquired nephrogenic diabetes insipidus; Congenital diabetes insipidus; NDI ... of very dilute urine. NDI is rare. Congenital diabetes insipidus is present at birth. It is a ...

  3. Microvascular diabetes complications in Wolfram syndrome (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness [DIDMOAD]): an age- and duration-matched comparison with common type 1 diabetes.

    Science.gov (United States)

    Cano, Aline; Molines, Laurent; Valéro, René; Simonin, Gilbert; Paquis-Flucklinger, Véronique; Vialettes, Bernard

    2007-09-01

    Some previous studies suggested that patients suffering from Wolfram syndrome or DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness) might be relatively preserved from diabetic retinopathy and nephropathy. However, these data were not conclusive because either observations were only anecdotic or did not match with control type 1 diabetic populations. A group of 26 French diabetic patients with DIDMOAD was compared with a population of 52 patients with common type 1 diabetes matched for age at diabetes diagnosis (8.62 +/- 1.84 vs. 8.27 +/- 1.30 years; P = NS) and diabetes duration (12.88 +/- 1.58 vs. 12.87 +/- 1.13 years; P = NS) to study the quality of glycemic control and the incidence of microvascular complications. Glycemic control was significantly better in the DIDMOAD group than in the type 1 diabetic group (A1C: 7.72 +/- 0.21 vs. 8.99 +/- 0.25%, respectively; P = 0.002), with significant lower daily insulin requirements (0.71 +/- 0.07 vs. 0.88 +/- 0.04 UI x kg(-1) x day(-1), respectively; P = 0.0325). The prevalence of microvascular complications in the DIDMOAD group was half that observed in the type 1 diabetic group, but the difference was not significant. Diabetes in DIDMOAD patients is more easily controlled despite the presence of other handicaps. This better glycemic control could explain the trend to decreased microvascular diabetes complications observed in previous studies.

  4. Pattern and distribution of peripheral arterial disease in diabetic ...

    African Journals Online (AJOL)

    Three risk factor combination groups were analysed: Group 1 (diabetes mellitus, hypertension, dyslipidemia), Group 2 (diabetes mellitus, hypertension, dyslipidemia, ex-smoker) and Group 3 (diabetes mellitus, hypertension, dyslipidemia, smoker). Results: Seventy-one patients were analysed (38 females and 33 males).

  5. Fatores terapêuticos em grupo de diabéticos Factores terapéuticos en grupo de diabéticos Therapeutic factors in a group of people with diabetes

    Directory of Open Access Journals (Sweden)

    Nunila Ferreira de Oliveira

    2009-09-01

    group of people with diabetes. An exploratory, assessing research carried out by means of semi-structured interviews pinpointed the following therapeutic factors: information availability (100%; cohesion (100%; universality (86%; interpersonal learning (57%; development of socialization techniques (57%; altruism (28.5%; imitative behavior (28.5%; and hope stimulus (28.5%. The implementation of group intervention actions for the promotion of self-care towards diabetes carriers can generate a beneficial interaction among group members, thus allowing for experience exchange processes, as well as a broader understanding of the disease and other positive experiences evidenced by the presence of the therapeutic factors.

  6. [Diabetes self-management and its association with diabetic retinopathy in patients with type 2 diabetes].

    Science.gov (United States)

    Li, Na; Yang, Xiu-fen; Deng, Yu; Gu, Hong; Ren, Xue-tao; Xu, Jun; Ma, Kai; Liu, Ning-pu

    2013-06-01

    To investigate the association of diabetic self-management with the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus. Cross-sectional study. Recruited patients with type 2 diabetes mellitus in the Desheng community of urban Beijing between November 2009 and May 2011. All patients were surveyed using a standardized questionnaire and underwent detailed ophthalmic examination. Patients were classified into DR group or diabetic without retinopathy (DWR) group according to the grading of fundus color photographs using the Early Treatment of Diabetic Retinopathy Study (ETDRS) standard grading protocol. In the DR group, proliferative diabetic retinopathy (PDR) was further defined. The overall levels of diabetes self-management in the study population were assessed and compared for the differences between DR and DWR, PDR and NPDR groups. One thousand one hundred patients with type 2 diabetes mellitus were recruited. The prevalence of DR was 32.1% (353/1100) in the study population. Sixty-three percent (652/1035) of patients had glycated hemoglobin (HbA1c) level less than 7.0%. The majority of patients (85.4%, 916/1072) conducted a diet control, 77.3% (827/1070) exercised, 56.0% (609/1088) monitored blood glucose regularly, 56.8% (416/733) detected HbA1c more than once every six months, 71.7% (762/1062) had ophthalmologic examination after the diagnosis of diabetes mellitus, and 47.9% (525/1097) had mydriatic check-up. Increased risk of DR was associated with longer duration of diabetes (more than 10 years) (OR = 3.90, 95% CI:2.97-5.51, P obedience to diet control (OR = 1.72, 95% CI:1.22-2.43, P obedience to diet control and less exercise, which suggest that lower level of diabetic self-management increased the risk of DR.

  7. [Gestational diabetes].

    Science.gov (United States)

    Mallet, B; Vialettes, B

    1990-01-01

    Gestational diabetes defined by either glucose intolerance or overt diabetes discovered during pregnancy is a real nosologic entity which is associated with risks for both foetus and mother. Unfortunately biological definition of gestational diabetes remains controversial. In North America it is defined by O'Sullivan's criteria (OGTT with 100 g of glucose for 3 hours), in Europe it is defined by WHO's criteria (OGTT with 75 g of glucose for 2 hours). Strategy for selection of high risk women who have to be submitted to OGTT is also matter of debate. Despite these uncertainties, everybody agrees that gestational diabetes is associated with high risk of foetal macrosomia and high rate of cesarean section. For the mother, gestational diabetes is a marker of future development of diabetes. Most of gestational diabetes are related to type II diabetes but some cases of type I diabetes are preceded by gestational diabetes. The treatment of gestational diabetes depends upon the severity of glucose intolerance. It is resumed by dietetic intervention associated, if necessary, with insulin therapy.

  8. [Diabetes mellitus: definition, classification and diagnosis].

    Science.gov (United States)

    Roden, Michael

    2016-04-01

    Diabetes mellitus comprises of a group of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classifications for diabetes mellitus type 1-4 are described and the main features of type 1 and type 2 diabetes are compared to allow for better discrimination between these diabetes types. Furthermore, the criteria for the correct biochemical diagnosis during fasting and oral glucose tolerance tests as well as the use of hemoglobin A1c (HbA1c) are summarized. These data form the basis of the recommendations of the Austrian Diabetes Association for the clinical praxis of diabetes treatment.

  9. [Diabetes mellitus--definition, classification and diagnosis].

    Science.gov (United States)

    Roden, Michael

    2004-01-01

    Diabetes mellitus comprises of a group of heterogeneous disorders which have an increase in blood glucose concentrations in common. The current classifications for diabetes mellitus type 1-4 are described and the main features of type 1 and type 2 diabetes are compared to allow for better discrimination between these diabetes types. Furthermore, the criteria for the correct biochemical diagnosis during fasting and during oral glucose tolerance tests are summarized. These data form the basis of the recommendations of the Austrian Diabetes Association for the clinical practice in diabetes.

  10. Association of PGC-1α gene with type 2 diabetes in three unrelated endogamous groups of North-West India (Punjab): a case-control and meta-analysis study.

    Science.gov (United States)

    Sharma, Rubina; Matharoo, Kawaljit; Kapoor, Rohit; Bhanwer, A J S

    2017-10-24

    PGC-1α (Peroxisome proliferator-activated receptor gamma, coactivator 1 alpha) plays a key role in glucose homeostasis inside liver and muscle. The impact of six polymorphisms of PGC-1α with Type 2 Diabetes (T2D) susceptibility was evaluated on 1125 samples comprising of 554 T2D cases and 571 controls among three endogamous groups (Bania, Brahmin and Jat Sikh) of North-West India (Punjab). Single-locus analysis showed a significant differential pattern of genetic association of PGC-1α among studied groups emphasizing the role of ethnicity towards disease susceptibility. Haplotypes G-A-G-G-C-C in Bania group; G-G-G-G-C-A in Brahmin; G-A-A-G-T-C, G-G-G-G-T-C in Jat Sikh groups conferred ~ two to fivefold increased T2D risk. Intriguingly, the haplotype combination G-A-G-G-C-C provided T2D risk in Banias whereas it played a protective role in Brahmins reflecting the role of ethnic heterogeneity. In the secondary structure prediction of mRNA, slight free energy change along with structural changes was observed between the wild and variant allele of rs3736265, rs8192678 and rs2970847 loci. Meta-analyses conducted on rs8192678 and rs2970847 variants illustrated the overall effect of minor alleles providing a higher risk for the T2D development. Divergence in genetic variants and haplotype combinations associated with T2D risk among studied groups is inferred from the present dataset, which strongly highlights the combinatorial effect of diverse ethnic background of the population under study with genetics towards susceptibility to complex diseases like T2D.

  11. Mild hypothyroidism improves glucose tolerance in experimental type 2 diabetes.

    Science.gov (United States)

    Ashwini, S; Bobby, Zachariah; Joseph, Manoj

    2015-06-25

    Co-existence of type 2 diabetes and hypothyroidism is an emerging trend observed in clinical practice. Although the effects of isolated type 2 diabetes and hypothyroidism are well known, there are limited studies addressing the metabolic complications when these two conditions co-exist. The aim of the present study was to assess the interaction between type 2 diabetes and hypothyroidism with respect to glucose tolerance, dyslipidemia and redox balance in a state were these two diseases coexist. Sixty male Wistar Albino rats were randomised into six groups. Group 1: control, Group 2: overt hypothyroidism, Group 3: mild hypothyroidism, Group 4: type 2 diabetes, Group 5: mild hypothyroidism + type 2 diabetes, Group 6: overt hypothyroidism + type 2 diabetes. Experimental hypothyroidism was created by the administration of propyl-2-thiouracil and type 2 diabetes by feeding rats with 60% fructose (w/w). The duration of the study was 6 weeks. All the parameters were estimated at the start (basal) and the end of the study. Intraperitoneal glucose tolerance test was carried out and area under curve (AUC) calculated to assess the glucose tolerance. Thyroid profile, lipid profile and oxidative stress parameters were also measured. Plasma TSH level was elevated 3-fold in the mild hypothyroid group and 15.2-fold in the overt hypothyroid group in comparison to the control group. Thyroid profile was found to be normal in type 2 diabetic group. There was no significant difference between hypothyroidism and hypothyroidism+diabetes groups with respect to thyroid profile. Among the six groups the degree of glucose intolerance was found to be maximum for overt hypothyroidism+diabetes group, followed by diabetes group and overt hypothyroidism group. An interesting finding was that glucose intolerance was significantly reduced in mild hypothyroidism+diabetes group (increase in AUC: 48.04%) in comparison with isolated diabetes group (increase in AUC: 71.63%). Similar results were

  12. [A questionnaire survey on current status of anti-diabetic therapy for diabetic patients with dementia].

    Science.gov (United States)

    Matsushita, Takaya; Yajima, Ken; Sumitomo, Hidetaka; Shigeta, Masayuki; Nishimura, Kazuhiro; Shirabe, Shinichiro; Sakai, Masashi; Katayama, Takashi; Kanno, Kazuo; Sakurai, Hirofumi; Nakano, Tadasumi; Kitaoka, Masafumi; Ueki, Akio

    2013-01-01

    It is important to establish treatment goals and optimal anti-diabetic therapy for diabetic patients with dementia. However, there are currently no established treatment guidelines. Recently, the West Tokyo Diabetes Association has established the Diabetes and Dementia Study Group to investigate the status of anti-diabetic therapy for diabetic patients with dementia. Here, we assessed the current status of such patients by a questionnaire survey. In November 2011, we conducted a mailed survey to the clinics and hospitals affiliated with Kita-Tama, Hachioji and Tachikawa Medical Associations in Tokyo, Japan. The survey evaluated the most suitable anti-diabetic therapy for elderly diabetic patients or diabetic patients with dementia, combined anti-diabetic therapy, insulin therapy for elderly diabetic patients and diabetic patients with dementia, combination therapy of insulin and oral anti-diabetic agents for diabetic patients with dementia, factors that make it difficult for diabetic patients with dementia to continue insulin therapy, and selection of treatment or care for diabetic patients with dementia. The responses indicated that the anti-diabetic agents appropriate for diabetic patients with dementia are dipeptidyl peptidase-4 inhibitors. Those inappropriate for the same patients are metformin and insulin. Family support was a major factor for insulin therapy continuation for diabetic patients with dementia. Moreover, anti-diabetic agents for these patients are selected according to their ease of use and compatibility with available familial and social resources. Our survey results can be utilized for the creation of new guidelines and educational resources for the anti-diabetic therapy of diabetic patients with dementia.

  13. Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week study.

    Science.gov (United States)

    Usharani, P; Mateen, A A; Naidu, M U R; Raju, Y S N; Chandra, Naval

    2008-01-01

    Hyperglycaemia leads to increased oxidative stress resulting in endothelial dysfunction. ACE inhibitors, antioxidants and HMG-CoA reductase inhibitors (statins) have been shown to improve endothelial function. The aim of this study was to compare the effects of NCB-02 (a standardized preparation of curcuminoids), atorvastatin and placebo on endothelial function and its biomarkers in patients with type 2 diabetes mellitus. A total of 72 patients with type 2 diabetes were randomized to receive NCB-02 (two capsules containing curcumin 150 mg twice daily), atorvastatin 10 mg once daily or placebo for 8 weeks. Endothelial function assessment was performed at baseline and post-treatment using digital volume plethysmography (salbutamol [albuterol] challenge test) to measure change in reflective index, an indicator of arterial vascular tone. Blood samples were similarly collected at baseline and post-treatment for estimations of malondialdehyde, endothelin-1 (ET-1), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNFalpha). Pre-and post-treatment safety assessments were also conducted. ANOVA and paired t-test evaluations were used for comparison. A total of 67 patients completed the study. At baseline, there was no significant difference in the various parameters tested. In all three groups, the change in reflective index at baseline was NCB-02 (-2.69 +/- 3.02% vs -8.19 +/- 5.73%, respectively). Similarly, patients receiving atorvastatin or NCB-02 showed significant reductions in the levels of malondialdehyde, ET-1, IL-6 and TNFalpha. No significant improvements were obtained in patients administered placebo. NCB-02 had a favourable effect, comparable to that of atorvastatin, on endothelial dysfunction in association with reductions in inflammatory cytokines and markers of oxidative stress. Further studies are needed to evaluate the potential long-term effects of NCB-02 and its combination with other herbal antioxidants.

  14. Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, P; Kühl, C; Bertelsen, C A

    1992-01-01

    of previous patients with gestational diabetes mellitus in whom plasma insulin was measured during an oral glucose tolerance test in late pregnancy a low insulin response at diagnosis was found to be an independent predictive factor for diabetes development. CONCLUSIONS: Women with previous dietary......OBJECTIVES: The purpose of this study was to determine the incidence of diabetes in women with previous dietary-treated gestational diabetes mellitus and to identify predictive factors for development of diabetes. STUDY DESIGN: Two to 11 years post partum, glucose tolerance was investigated in 241...... women with previous dietary-treated gestational diabetes mellitus and 57 women without previous gestational diabetes mellitus (control group). RESULTS: Diabetes developed in 42 (17.4%) women with previous gestational diabetes mellitus (3.7% insulin-dependent diabetes mellitus and 13.7% non...

  15. High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia

    DEFF Research Database (Denmark)

    Clausen, Tine D; Mathiesen, Elisabeth R; Hansen, Torben

    2008-01-01

    the background population (O-BP). RESULTS: The prevalence of type 2 diabetes and pre-diabetes (impaired glucose tolerance or impaired fasting glucose) in the four groups was 21, 12, 11, and 4%, respectively. In multiple logistic regression analysis, the adjusted odds ratios (ORs) for type 2 diabetes/pre-diabetes......OBJECTIVE: The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia...... and genetic predisposition to type 2 diabetes into account. RESEARCH DESIGN AND METHODS: The glucose tolerance status following a 2-h 75-g oral glucose tolerance test (OGTT) was evaluated in 597 subjects, primarily Caucasians, aged 18-27 years. They were subdivided into four groups according to maternal...

  16. Pregnancy and progression of diabetic nephropathy

    DEFF Research Database (Denmark)

    Rossing, K; Jacobsen, P; Hommel, E

    2002-01-01

    as control subjects (group B). All patients received aggressive antihypertensive treatment (blood pressure goal diabetic nephropathy regarding blood pressure, albuminuria, s-cholesterol, smoking, retinopathy and s-creatinine (mean 79(SD 23......AIMS/HYPOTHESIS: Pregnancy could damage kidney function in diabetic nephropathy. We investigated the long-term impact of pregnancy on the progression of diabetic nephropathy. METHODS: Our observational follow-up study included all women patients with Type I (insulin-dependent) diabetes mellitus who...... developed diabetic nephropathy between 1970 and 1989 at Steno Diabetes Center (n = 93). Follow-up lasted 16 years (range 3-28) from the onset of diabetic nephropathy until death or the year 2000. A total of 26 women became pregnant after the onset of diabetic nephropathy (group A). The remaining 67 served...

  17. Diabetes among migrants in Denmark

    DEFF Research Database (Denmark)

    Andersen, Gregers Stig; Kamper-Jørgensen, Zaza; Carstensen, Bendix

    2016-01-01

    OBJECTIVE: Studies of diabetes in migrant populations have shown a higher prevalence compared to their respective countries of origin and to people natively born in the host country, but there is little population-based data on diabetes incidence and mortality in migrant populations. The aim...... of the current study was (1) to describe the incidence rates and prevalence of diabetes among first generation migrants in Denmark compared to the Danish background population, and (2) to compare standardised mortality rates (SMRs) for individuals with and without diabetes according to country of origin...... to the part of the population without diabetes were calculated based on follow up of the entire Danish population. RESULTS: Compared with native born Danes, the incidence of diabetes was about 2.5 times higher among migrants from Africa, Asia, and the Middle East, and these migrant groups also showed...

  18. Association of the WFS1 gene with disease progression in children with new onset T1D. Results from the Hvidoere study group on childhood diabetes

    DEFF Research Database (Denmark)

    Nielsen, L.B.; Andersen, M.L.M.; Svensson, Jannete

    2010-01-01

    with proinsulin (est.: 1.55, P = 0.005) the first 12 month after disease onset compared to the AA genotype carriers. Conclusions: A common variant of the WFS1 gene is highly associated with better residual beta-cell function and corresponding better metabolic control during disease progression in new onset T1D...... variants the Wolfram syndrome. The aim of this study was to investigate the impact of a common genetic variant (rs10010131) of the WFS1 gene on disease progression in a group of children newly diagnosed with T1D. Methods: The study is a multicenter longitudinal investigation with 18 participating...... paediatric centres from 15 countries. Clinical information and blood samples were collected from 275 children less than 16 years at diagnosis and at 1, 6, and 12 months after onset. Genotyping of the rs10010131 variant was done by KBioscience using an in-house KASPar assay system. Statistics: C-peptide, HbA1...

  19. Association of the WFS1 gene with disease progression in children with new onset T1D. Results from the Hvidoere study group on childhood diabetes

    DEFF Research Database (Denmark)

    Nielsen, L.B.; Andersen, Marie Louise Max; Svensson, Jannete

    2010-01-01

    Objective: The wolframin gene, WFS1, encodes a glucoprotein involved in the calcium homeostasis of the endoplasmatic reticulum; WFS1 is critical for the function and survival of the pancreatic beta-cells. Genetic variation within the WFS1 gene is known to be associated with T2D and for rare...... variants the Wolfram syndrome. The aim of this study was to investigate the impact of a common genetic variant (rs10010131) of the WFS1 gene on disease progression in a group of children newly diagnosed with T1D. Methods: The study is a multicenter longitudinal investigation with 18 participating...... paediatric centres from 15 countries. Clinical information and blood samples were collected from 275 children less than 16 years at diagnosis and at 1, 6, and 12 months after onset. Genotyping of the rs10010131 variant was done by KBioscience using an in-house KASPar assay system. Statistics: C-peptide, HbA1...

  20. Streptozotocin produces oxidative stress, inflammation and decreases BDNF concentrations to induce apoptosis of RIN5F cells and type 2 diabetes mellitus in Wistar rats.

    Science.gov (United States)

    Bathina, Siresha; Srinivas, Nanduri; Das, Undurti N

    2017-04-29

    Neurodegenerative disorders, such as deficits in learning, memory and cognition and Alzheimer's disease are associated with diabetes mellitus. Brain-derived neurotrophic factor (BDNF) is a neurotrophic factor and is known to possess anti-obesity, anti-diabetic actions and is believed to have a role in memory and Alzheimer's disease. To investigate whether STZ can reduce BDNF production by rat insulinoma (RIN5F) cells in vitro and decrease BDNF levels in the pancreas, liver and brain in vivo. Streptozotocin (STZ)-induced cytotoxicity to RIN5F cells in vitro and type 2 DM in Wistar rats was employed in the present study. Cell viability, activities of various anti-oxidants and secretion of BDNF by RIN5F cells in vitro were measured using MTT assay, biochemical methods and ELISA respectively. In STZ-induced type 2 DM rats: plasma glucose, interleukin-6 and tumor necrosis factor-α levels and BDNF protein expression in the pancreas, liver and brain tissues were measured. In addition, neuronal count and morphology in the hippocampus and hypothalamus areas was assessed. STZ-induced suppression of RIN5F cell viability was abrogated by BDNF. STZ suppressed BDNF secretion by RIN5F cells in vitro. STZ-induced type 2 DM rats showed hyperglycemia, enhanced plasma IL-6 and TNF-αlevels and reduced plasma and pancreas, liver and brain tissues (P stress compared to untreated control. Hypothalamic and hippocampal neuron in STZ-treated animals showed a decrease in the number of neurons and morphological changes suggesting of STZ cytotoxicity. The results of the present study suggest that STZ is not only cytotoxic to pancreatic beta cells but also to hypothalamic and hippocampal neurons by inducing oxidative stress. STZ ability to suppress BDNF production by pancreas, liver and brain tissues suggests that impaired memory, learning, and cognitive dysfunction seen in diabetes mellitus could be due to BDNF deficiency. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Diabetes Distress and Depression in South Asian Canadians with Type 2 Diabetes.

    Science.gov (United States)

    Sidhu, Rawel; Tang, Tricia S

    2017-02-01

    South Asians are disproportionately affected by diabetes compared to some other ethnic groups in Canada. Although depression and diabetes distress are psychological issues well studied in the general population of those with diabetes, they have not been investigated in South Asian Canadians with type 2 diabetes. We sought to identify the rates of depression and diabetes distress in South Asian adults with type 2 diabetes and to explore the relationship among glycemic control, depression and diabetes distress. We recruited 41 South Asian adults with type 2 diabetes for this study. Glycated hemoglobin (A1C) levels were collected via venous puncture. We utilized the Diabetes Distress Scale to assess total diabetes distress and its subscales (emotional distress, interpersonal distress, regimen-related distress and physician distress) and the Personal Health Questionnaire-9 to assess depressive symptoms. The rate of depression was 15%, and the rate of total diabetes distress was 52.5%. Although neither measure was found to be correlated with A1C levels, depression had a moderate positive correlation with total diabetes distress (r=0.696; pdiabetes distress is a serious concern for South Asian Canadians with type 2 diabetes. Given that depression and diabetes distress are linked, studies recruiting a larger and more diverse sample of South Asian Canadians should be conducted to better understand the psychological issues that may impact diabetes self-management in this community. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  2. Coronary artery bypass surgery in the diabetic patient.

    LENUS (Irish Health Repository)

    Maher, M

    2012-02-03

    Coronary artery and peripheral occlusive arterial disease frequently complicate diabetes mellitus, with death due to atherosclerotic coronary artery disease being three times more likely in diabetic compared to non-diabetic patients. The profile of 32 diabetic patients and 32 matched controls who underwent coronary artery bypass (CABG) is studied and their early and late postoperative outcomes are described. The mean age was 61 +\\/- 1 year in both groups. The diabetic group comprised 26 non-insulin dependent and 6 insulin dependent diabetics, who had a mean duration of diabetes of 8.5 years (range 2 months--35 years). The median number of grafts per patient performed in the diabetic group and the control group was 3.5 and 3 respectively. There was no mortality in the series, however considerably greater wound morbidity rates were encountered in the diabetic group when compared to matched controls. One renal transplant patient in the diabetic group suffered irreversible acute tubular necrosis and became dialysis dependent post-operatively. Longterm follow-up showed no longterm mortality in either group, with full relief of angina achieved in 75% of diabetic patients compared with 87.5% of matched controls. In addition diabetic patients suffered greater longterm cardiac morbidity than the control group (21.8% versus 12.5%). The results of this study suggest that CABG is a safe operation for the diabetic patient. Diabetic patients receive satisfactory symptomatic relief of angina, but suffer increased perioperative wound complications and greater incidence of longterm cardiac morbidity.

  3. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial.

    Science.gov (United States)

    Sorli, Christopher; Harashima, Shin-Ichi; Tsoukas, George M; Unger, Jeffrey; Karsbøl, Julie Derving; Hansen, Thomas; Bain, Stephen C

    2017-04-01

    Despite a broad range of pharmacological options for the treatment of type 2 diabetes, optimum glycaemic control remains challenging for many patients and new therapies are necessary. Semaglutide is a glucagon-like peptide-1 (GLP-1) analogue in phase 3 development for type 2 diabetes. We assessed the efficacy, safety, and tolerability of semaglutide monotherapy, compared with placebo, in treatment-naive patients with type 2 diabetes who had insufficient glycaemic control with diet and exercise alone. We did a double-blind, randomised, parallel-group, international, placebo-controlled phase 3a trial (SUSTAIN 1) at 72 sites in Canada, Italy, Japan, Mexico, Russia, South Africa, UK, and USA (including hospitals, clinical research units, and private offices). Eligible participants were treatment-naive individuals aged 18 years or older with type 2 diabetes treated with only diet and exercise alone for at least 30 days before screening, with a baseline HbA1c of 7·0%-10·0% (53-86 mmol/mol). We randomly assigned participants (2:2:1:1) to either once-weekly subcutaneously injected semaglutide (0·5 mg or 1·0 mg), or volume-matched placebo (0·5 mg or 1·0 mg), for 30 weeks via prefilled PDS290 pen-injectors. Participants did their own injections and were encouraged to administer them on the same day of each week in the same area of their body; the time of day and proximity of meal times was not specified. We did the randomisation with an interactive voice or web response system. Investigators, participants, and the funder of the study remained masked throughout the trial. The primary endpoint was the change in mean HbA1c from baseline to week 30, and the confirmatory secondary endpoint was the change in mean bodyweight from baseline to week 30. We assessed efficacy and safety in the modified intention-to-treat population (ie, all participants who were exposed to at least one dose of study drug); both placebo groups were pooled for assessment. This trial was registered

  4. Education for diabetic foot

    Directory of Open Access Journals (Sweden)

    Fabio Batista

    2009-03-01

    Full Text Available Objective: The purpose of this investigation was to stratify the risk in a consecutive group of diabetic patients presenting, for the first time, in a diabetic foot clinic. Additional aims were to investigate the preventive measures in the local health system and to evaluate the level of patient’s awareness about diabetic foot-associated morbidity. Methods: Fifty consecutive adult diabetic patients referred to a Diabetic Foot Clinic of a Municipal Public Hospital comprised the sample for this observational study. The enrollment visit was considered as the first health-system intervention for potential foot morbidity. The average time elapsed since a diagnosis of diabetes among patients was five years. Rresults: At the time of presentation, 94% of sample was not using appropriate footwear. Pedal pulses (dorsalis pedis and/or posterior tibial arteries were palpable in 76% of patients. Thirty subjects (60% had signs of peripheral neuropathy. Twenty-one subjects (42% had clinical deformity. There was a positive correlation between a history of foot ulcer, the presence of peripheral neuropathy, and the presence of foot deformity (p < 0.004 in each correlation. Cconclusions: Informing and educating the patients and those interested in this subject and these problems is essential for favorable outcomes in this scenario.

  5. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  6. Type 1 diabetes mellitus and periodontal disease : relationship to different clinical variables

    OpenAIRE

    Silvestre Donat, Francisco Javier; Miralles Jordá, Lucía; Llambés Arenas, Fernando; Bautista, Daniel; Solá Izquierdo, Eva; Hernández Mijares, Antonio

    2009-01-01

    Objective: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications. Methods: A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was perfor...

  7. Women and Diabetes

    Medline Plus

    Full Text Available ... diabetes. Food Safety for People with Diabetes Your Glucose Meter - easy-to-read booklet for women Other ... Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need ...

  8. Women and Diabetes

    Medline Plus

    Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

  9. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Your Child About the News Brain and Nervous System Cancers When Your Child Needs a Kidney Transplant ... Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes Center Diabetes: DJ's Story (Video) Diabetes: Marco's ...

  10. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals ... Movie Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes Center Diabetes: DJ's Story (Video) Diabetes: Marco's ...

  11. Type 1 diabetes

    Science.gov (United States)

    Insulin-dependent diabetes; Juvenile onset diabetes; Diabetes - type 1; High blood sugar - type 1 diabetes ... Type 1 diabetes can occur at any age. It is most often diagnosed in children, adolescents, or young adults. Insulin is ...

  12. Living With Diabetes

    Science.gov (United States)

    ... Other Dental Problems Diabetes & Sexual & Urologic Problems Managing Diabetes You can manage your diabetes and live a ... you have diabetes. How can I manage my diabetes? With the help of your health care team, ...

  13. Diabetes Fact Sheet

    Science.gov (United States)

    ... this section Home A-Z Health Topics Diabetes Diabetes > A-Z Health Topics Diabetes (PDF, 438 KB) ... To receive Publications email updates Enter email Submit Diabetes Diabetes is a disease in which blood sugar ( ...

  14. Diabetes eye exams

    Science.gov (United States)

    Diabetic retinopathy - eye exams; Diabetes - eye exams; Glaucoma - diabetic eye exam; Macular edema - diabetic eye exam ... if the doctor who takes care of your diabetes checks your eyes, you need an eye exam ...

  15. Types of Diabetes

    Science.gov (United States)

    ... Dental Problems Diabetes & Sexual & Urologic Problems What is Diabetes? Diabetes is a disease that occurs when your ... is serious. What are the different types of diabetes? The most common types of diabetes are type ...

  16. Genetics of Diabetes

    Science.gov (United States)

    ... A A A Listen En Español Genetics of Diabetes You've probably wondered how you developed diabetes. ... to develop diabetes than others. What Leads to Diabetes? Type 1 and type 2 diabetes have different ...

  17. Women and Diabetes

    Medline Plus

    Full Text Available ... has lots of free information to help you manage your diabetes. General Tips Diabetes Treatments Diabetes and ... Check these resources for tips to help you manage your diabetes. Food Safety for People with Diabetes ...

  18. Glycemic Index and Diabetes

    Science.gov (United States)

    ... Camp Fundraising Events Step Out Walk to Stop Diabetes Tour de Cure Father of the Year Stop Diabetes at School ... Forecast Stop Diabetes Step Out: Walk to Stop Diabetes Tour de Cure Living With Type 2 Diabetes Recipes for Healthy ...

  19. Erectile Dysfunction and Diabetes

    Science.gov (United States)

    ... Camp Fundraising Events Step Out Walk to Stop Diabetes Tour de Cure Father of the Year Stop Diabetes at School ... Forecast Stop Diabetes Step Out: Walk to Stop Diabetes Tour de Cure Living With Type 2 Diabetes Recipes for Healthy ...

  20. Diabetes and Kidney Disease

    Science.gov (United States)

    ... Health Guide Diabetes - A Major Risk Factor for Kidney Disease Print Email Diabetes mellitus, usually called diabetes, ... Asian Americans. What does diabetes do to the kidneys? With diabetes, the small blood vessels in the ...

  1. School and Diabetes

    Science.gov (United States)

    ... trips recognize and get treatment for low blood sugar episodes Diabetes management materials that need to go to school ... With Feelings 504 Education Plans School and Diabetes Carbohydrates and Diabetes Handling Diabetes When You're Sick Diabetes Control: ...

  2. Diabetes Movie (For Parents)

    Medline Plus

    Full Text Available ... Visit KidsHealth in the Classroom What Other Parents Are Reading Is Your Child Too Busy? Helping Your ... Diabetes: Lindsey's Story (Video) Diabetes Center Movie: Endocrine System Diabetes Center Diabetes: DJ's Story (Video) Diabetes: Marco's ...

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

    Directory of Open Access Journals (Sweden)

    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

  4. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  5. Liver function of Streptozotocin- Induced Diabetic Rats Orally ...

    African Journals Online (AJOL)

    This study evaluated the liver status of STZ- induced diabetic rats treated with aqueous root-bark extract of T. tetraptera for 35 days. Twenty-four (24) rats in four groups (normal control, diabetic control, T. tetraptera treated STZ induced diabetic rats at 150 mg/kg b. w. and T. tetraptera treated STZ-diabetic rats at 300 mg/kg ...

  6. Survey on knowledge and attitudes regarding diabetic in-patient ...

    African Journals Online (AJOL)

    Doctors and nurses taking care of diabetic inpatients were surveyed to assess their knowledge of diabetes inpatient management and their attitudes towards diabetic patients. The survey made use of the diabetes knowledge questionnaire (O'Brien) and the DAS3 scale. Results. The survey group comprised 115 health care ...

  7. Wound Healing Potential of Natural Honey in Diabetic and Non ...

    African Journals Online (AJOL)

    The cutaneous wound healing effects of natural honey were compared in diabetic and non-diabetic rats. Thirty adult male Wistar rats (159g ± 31.5) where randomized into alloxan diabetics (n=15) and non-diabetic (n=15) groups. A 6mm full thickness biopsy punch wound was created on the nape of each rat under 2% ...

  8. [The clinicopathological characteristics of diabetic nephropathy and non-diabetic renal diseases in diabetic patients].

    Science.gov (United States)

    Xu, J; Hu, X F; Huang, W; Shen, P Y; Zhang, W; Ren, H; Li, X; Wang, W M; Chen, N; Pan, X X

    2017-12-01

    Objective: To analyze the clinicopathological characteristics of renal lesions in type 2 diabetic patients and to differentiate diabetic nephropathy (DN) from non-diabetic renal diseases(NDRD). Methods: Type 2 diabetic patients who received renal biopsy in Ruijin Hospital from January 2011 to December 2015 were recruited in this study. Clinical history, laboratory results and pathological data were retrospectively collected. According to the pathological findings, the patients were divided into 3 groups: DN, NDRD, DN+NDRD. Logistic model was applied to explore the independent clinical predictive factors in differentiating DN from NDRD. Results: A total of 207 type 2 diabetic patients received renal biopsy, accounting for 6.82% of all biopsy population. Fifty-one patients were diagnosed with DN, 142 with NDRD and 14 with both DN and NDRD. In NDRD, membranous nephropathy(MN)(34.5%) was the most common finding, followed by IgA nephropathy(19.7%).By contrast, NDRD patients manifested a shorter diabetic course, a higher baseline hemoglobin level, a lower baseline serum creatinine, a higher prevalence of hematuria, a lower prevalence of hypertension and diabetic retinopathy, a better control of blood glucose, better compliance of monitoring blood glucose and less family history of diabetes. In multivariate logistic model, diabetic family history( OR= 4.68, P= 0.04) and long history of diabetes( OR= 1.01, P= 0.02) were risk factors of DN. Conclusion: There is a high prevalence of NDRD in diabetic patients with renal lesions. Family history of diabetes and duration of diabetes are independent predictors of DN.

  9. Cost-effectiveness of the psycho-educational blended (group and online) intervention HypoAware compared with usual care for people with Type 1 and insulin-treated Type 2 diabetes with problematic hypoglycaemia: analyses of a cluster-randomized controlled trial

    NARCIS (Netherlands)

    de Wit, M.; Rondags, S. M. P. A.; van Tulder, M. W.; Snoek, F. J.; Bosmans, J. E.

    2018-01-01

    Aims To evaluate the cost-effectiveness of HypoAware, a blended (group and online) psycho-educational intervention based on the evidence-based Blood Glucose Awareness Training, in comparison with usual care in people with Type 1 and Type 2 diabetes with a high risk of severe hypoglycaemia. Methods

  10. Diabetic autoimmune markers in children and adolescents with type 2 diabetes.

    Science.gov (United States)

    Hathout, E H; Thomas, W; El-Shahawy, M; Nahab, F; Mace, J W

    2001-06-01

    There is an increase in the incidence of type 2 diabetes in children and adolescents. Absence of known diabetes autoimmune markers is sometimes required to confirm the diagnosis. To identify clinical and autoimmune characteristics of type 2 diabetes in a pediatric population. We report an analysis of 48 children and adolescents with type 2 diabetes, compared with 39 randomly selected children with type 1 diabetes, diagnosed and followed at the Loma Linda University Pediatric Diabetes Center. Ethnic, familial, seasonal, and autoimmune marker characteristics are outlined. To determine the reliability of antibody testing in confirming the type of diabetes at diagnosis, we studied the incidence of positive islet cell antibodies (ICAs), glutamic acid decarboxylase antibodies (GADs), and insulin autoantibodies (IAAs) at diagnosis in both groups. ICA512, GADs, and IAAs were measured by radioimmunoassay. The cohort with type 2 diabetes had a similar gender distribution as the group with type 1 diabetes but a significantly higher age at diagnosis. Ethnic background was significantly different between the 2 groups, predominantly Hispanic in type 2 and white in type 1. Body mass index was significantly higher in type 2 diabetes (mean = 31.24 kg/m(2)). Among the patients with type 2 diabetes, 33% presented in diabetic ketoacidosis, random blood glucose at diagnosis ranged from 11.4 to 22.25 mmol/L (228-445 mg/dL), fasting C-peptide levels ranged from 0.89 to 2.7 nmol/L (2.7-8.2 ng/mL; normal: <1.36 nmol/L), and hemoglobin A(1C) was 10.8 +/- 3.5% (normal: <6.6%). None of these parameters was significantly different from the type 1 diabetes group. Although the incidence of diabetes antibody markers was significantly lower in type 2 versus type 1 diabetes, 8.1% of patients with type 2 diabetes had positive ICAs, 30.3% had positive GADs, and 34.8% had positive IAAs without ever being treated with insulin. In the type 2 diabetes group, none of the Hispanic patients had ICAs

  11. Diabetes and Pregnancy: Gestational Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-14

    Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

  12. Conocimientos, destrezas y conductas ante el cuidado de los pies en un grupo de amputados diabéticos Knowledge, abilities and behaviours in foot care in a group of diabetic amputees

    Directory of Open Access Journals (Sweden)

    Rolando Suárez Pérez

    2001-08-01

    Full Text Available Se conoce que el cuidado de los pies, uno de los mayores retos en la atención a personas diabéticas, no se enfoca adecuadamente en las consultas de rutina por lo cual se pierde la función preventiva de las complicaciones en miembros inferiores y su máxima manifestación: la amputación. Para lograr un acercamiento a este problema el trabajo tuvo como objetivo determinar la información y las orientaciones prácticas que tenía un grupo de pacientes diabéticos que sufrían una amputación en el momento del estudio. Se entrevistaron 105 diabéticos hospitalizados en las salas de Angiología de 2 hospitales generales. La entrevista se dirigió a recoger información que permitiera caracterizar el actual proceso de amputación y determinar la información y las orientaciones prácticas que sobre el cuidado de los pies en general y su proceso particular de amputación, habían recibido estas personas. Se encontró que el 62,5 % del grupo no revisaba periódicamente sus pies y el 42,4 % no identificó como peligrosas algunas prácticas caseras ante callosidades, cortado de uñas, etc. Solamente el 29,5 % pudo identificar 1 ó 2 cuidados prácticos de los pies. Se comprobó que no habían recibido información práctica al respecto y que en el 52,4 %, el inicio de la presente complicación fue por descuido, errores de conducta o ignorancia de cómo proceder. Se concluyó que una intervención educativa podría haber contribuido sustancialmente a reducir las amputacionesIt is known that foot care, one of the biggest challenges for diabetic persons care, is not adequately approached in regular appointments and that is why the function of preventing the occurrence of complications in lower limbs and its top manifestation, that is, amputation, is lost. To address this problem, the present paper was aimed at determining the information and practical orientations received by a group of diabetic patients suffering from amputation at the time of the study

  13. Association of socio-economic status with diabetes prevalence and utilization of diabetes care services

    Directory of Open Access Journals (Sweden)

    Svenson Lawrence W

    2006-10-01