社区糖尿病高危人群预防性健康教育的实施

目的提高社区糖尿病高危人群对糖尿病的扒知能力，降低糖尿病的发病率。方法对社区糖尿病高危人群采用多种方式实施预防性健康教育活动。结果预防性健康教育6个月后社区糖尿病高危人群对糖尿病基本知识的知晓率及自我管理状况显著优于教育前（均P〈0．05、P〈0．01）；无1例新增糖尿病患者。结论对社区糖尿病高危人群开展预防性健康教育．能有效提高社区糖尿病高危人群对糖尿病的认知能力．有效降低糖尿病的发病率。     

社区糖尿病高危人群预防性健康教育的实施

目的 提高社区糖尿病高危人群对糖尿病的认知能力,降低糖尿病的发病率.方法 对社区糖尿病高危人群采用多种方式实施预防性健康教育活动.结果 预防性健康教育6个月后社区糖尿病高危人群对糖尿病基本知识的知晓率及自我管理状况显著优于教育前(均P＜0.05、P＜0.01);无1例新增糖尿病患者.结论 对社区糖尿病高危人群开展预防性健康教育,能有效提高社区糖尿病高危人群对糖尿病的认知能力,有效降低糖尿病的发病率.     

某大学社区教职工糖尿病高危人群生活方式早期干预

目的:探讨2型糖尿病高危个体进行生活方式干预的临床效果.方法:知已能量盐测仪和知己健康管理软件对本校教工筛查人群中的2型糖尿病高危个体72例进行运动和饮食管理指导,观察干预首、后的体重、体重指数、腰围、血压、生化指标(空腹血糖、血脂四项)变化,并进行统计学比较.结果:经对72例高危个体6个月的生活方式干预,体重、体重指数、腰围、血压、甘油三酯、总胆固醇、低密度脂蛋白均下降,并有统计学意义(P<0.05),高密度脂蛋白也有不同程度的改善,但无统计学意义(P>0.05).结论:对2型糖尿病高危个体进行生活方式干预效果显著,方便可行,值得宣传和推广.     

生活方式干预对血脂异常人群的影响

目的 探讨生活方式干预对血脂异常人群的影响。方法 将60例参加健康体检的符合血脂异常且无其他严重并存疾病的患者随机分为两组各30例。对照组仅进行相关知识宣教；干预组实施生活方式干预．依据个体差异制定合理的膳食结构、运动方式及运动量．建立联系监督本．每周电话沟通1次．每月回访1次。3个月后进行评价。结果 干预后干预组膳食结构、运动、体重改善率均显著优于对照组（均P〈0.01）．总胆固醇、甘油三酯、低密度脂蛋白胆固醇均显著低于对照组（均P〈0.05）。结论 生活方式干预可增强患者的保健意识和自我管理能力，从而有效控制血脂水平。     

生活方式干预对血脂异常人群的影响

目的探讨生活方式干预对血脂异常人群的影响.方法将60例参加健康体检的符合血脂异常且无其他严重并存疾病的患者随机分为两组各30例.对照组仅进行相关知识宣教;干预组实施生活方式干预,依据个体差异制定合理的膳食结构、运动方式及运动量,建立联系监督本,每周电话沟通1次,每月回访1次.3个月后进行评价.结果干预后干预组膳食结构、运动、体重改善率均显著优于对照组(均P<0.01),总胆固醇、甘油三酯、低密度脂蛋白胆固醇均显著低于对照组(均P<0.05).结论生活方式干预可增强患者的保健意识和自我管理能力,从而有效控制血脂水平.     

农村居民2型糖尿病高危因素分析及护理对策

目的 调查夷陵区农村居民糖尿病的高危因素,并提出护理对策以加强对农村居民糖尿病的防治工作.方法 采取分层整群抽样的方式,对9 871名农村居民进行问卷调查及体检.结果 农村居民2型糖尿病的高危因素主要有缺乏体力活动、饮酒、膳食不均衡等不良生活方式,以及BMI、腰臀比异常及高血压、高血脂等临床指标异常.结论 农村居民对2...     

妊娠期糖尿病高危孕妇基于跨理论模型的护理干预

目的 探讨妊娠期糖尿病高危孕妇基于跨理论模型的护理干预效果.方法 将产科门诊行产检的88例妊娠期糖尿病高危孕妇按照产检时间段入组,对照组和干预组各44例.对照组实行常规护理干预,干预组在常规护理干预基础上实施基于跨理论模型的护理干预.比较两组孕妇妊娠期糖尿病发病率、糖耐量试验血糖水平、妊娠期糖尿病自我管理能力以及自我效...     

老年2型糖尿病患者社区护理干预的研究现状

综述老年2型糖尿病患者的社区护理干预措施,以及实施社区护理对患者生存质量的影响.通过有效社区护理干预的实施,提高患者遵从医嘱执行药物治疗、合理饮食、科学运动、血糖监测等的自我管理意识、能力和水平,从而有效提高其生活质量.     

老年2型糖尿病患者运动疗法中的护理干预

目的 探讨老年2型糖尿病患者在运动疗法中实施护理干预的效果.方法 将70例老年2型糖尿病患者随机分为干预组和对照组各35例.两组均给予饮食、心理疗法及药物治疗.对照组自行锻炼,干预组对运动疗法中的运动方式、强度、时间、时机等进行护理干预.结果 干预1个月后,干预组空腹血糖、餐后2 h血糖、糖化血红蛋白值显著低于对照组(均P＜0.05);同时干预组血压改善明显(均P＜0.05),血糖水平控制总有效率达80.00%(均P＜0.05).结论 对老年2型糖尿病患者的运动疗法实施护理干预,可使运动安全有效,不但减少了降糖药物的用量,缩短疗程,延缓了并发症的发生和发展,而且提高了患者的生活质量.     

老年2型糖尿病患者运动疗法中的护理干预

目的探讨老年2型糖尿病患者在运动疗法中实施护理干预的效果。方法将70例老年2型糖尿病患者随机分为干预组和对照组各35例。两组均给予饮食、心理疗法及药物治疗。对照组自行锻炼，干预组对运动疗法中的运动方式、强度、时间、时机等进行护理干预。结果干预1个月后，干预组空腹血糖、餐后2h血糖、糖化血红蛋白值显著低于对照组（均P〈0．05）；同时干预组血压改善明显（均P〈0．05），血糖水平控制总有效率达80．00％（均P〈0．05）。结论对老年2型糖尿病患者的运动疗法实施护理干预，可使运动安全有效，不但减少了降糖药物的用量，缩短疗程，延缓了并发症的发生和发展，而且提高了患者的生活质量。     

Mechanistic studies of lifestyle interventions in type 2 diabetes

AIM:To investigate the effect of lifestyle interventions in the non-pharmacological management of type 2 diabetes via a mechanistic approach.METHODS:A randomized controlled trial was carried out on 60 type 2 diabetic male and female volunteers that fulfilled the inclusion criteria,with their proper consent and permission of the International Electrotechnical Commission for 1 year.30 patients were included in the test group and 30 patients in the control group.Demographic details,anthropometrical status,physical activity,food habits and blood glucose lipid profile of the volunteers were recorded at baseline,the test group was directed for lifestyle intervention and final blood glucose lipid data were collected at the end of one year of patient follow-up.RESULTS:After 1 year,the test group who had a lifestyle intervention was found to show a significant improvement in blood glucose lipid profile.The fasting plasma glucose level(FPG),postprandial plasma glucose level(PPG),glycosylated hemoglobin(HbA1c) and body mass index(BMI) values of the test group were reduced significantly,up to 145 ± 2.52,174 ± 2.59,6.3 ± 0.32 and 25 ± 0.41 respectively at the end of the study period,in comparison to the control group whereFPG,PPG,HbA1c and BMI values were 193 ± 3.36,249 ± 4.24,7.2 ± 0.42 and 26 ± 0.65 respectively.Improvement in the total cholesterol(TC),triglyceride(TG),high-density lipoproteins(HDL) and low-density lipoproteins(LDL) values of the test group was also remarkable in comparison to the control group.The TC,TG,HDL and LDL values of the test group were reduced significantly,up to 149 ± 3.32,124 ± 2.16,58 ± 0.62 and 118 ± 2.31,respectively.CONCLUSION:The significant improvement in the blood glucose lipid profile of the test group after 1 year signifies the value of non-pharmacological management of type 2 diabetes via lifestyle intervention strategies.     

Attenuating type 2 diabetes with postpartum interventions following gestational diabetes mellitus

Women with a history of gestational diabetes should be screened during and after the postpartum period because of a high risk for developing type 2 diabetes mellitus. Although differences exist between guidelines practiced throughout various parts of the world, all recommend the use of cutoffs for fasting and/or post-load plasma glucose to diagnose diabetes or pre-diabetes. The use of these glycemic parameters could be optimized when a trend is observed, rather than considering them as isolated values at various time points. As the presence of insulin resistance and beta-cell dysfunction start before glycemic changes are evident, the estimation of insulin sensitivity and beta-cell function by Homeostatic Model Assessment is suggested for women who have additional risk factors for diabetes, such as obesity. Disease-modifying lifestyle intervention should be the first-line strategy to prevent or delay the onset of diabetes in women with a history of gestational diabetes mellitus. Intensive lifestyle interventions are designed to decrease caloric intake and increase physical activity in order to reduce body weight and fat, which will in turn reduce insulin resistance. This article also reviews unique problems of postpartum women, which should be considered when designing and implementing an intervention. Innovative “out of the box” thinking is appreciated, as continued adherence to a program is a challenge to both the women and the health care personnel who deal with them.     

Cost-effectiveness analysis of lifestyle interventions for preventing kidney disease in patients with type 2 diabetes

Clinical and Experimental Nephrology - Lifestyle interventions in patients with type-2 diabetes contribute to reducing the incidence of chronic kidney disease. The cost-effectiveness of lifestyle...     

Successful lifestyle modifications may underlie umbilical cord-mesenchymal stromal cell effects in type 2 diabetes mellitus

Type 2 diabetes mellitus(T2DM) is a lifelong condition and a grave threat to human health. Innovative efforts to relieve its detrimental effects are acutely needed. The sine qua non in T2DM management is consistent adherence to a prudent lifestyle and nutrition, combined with aerobic and resistance exercise regimens, together repeatedly shown to lead to complete reversal and even longterm remission. Non-adherence to the above lifestyle adjustments condemns any treatment effort and ultimately the...     

Impact of diabetes mellitus on outcomes of superficial femoral artery endoluminal interventions

BACKGROUND: Although aggressive endoluminal therapy for superficial femoral artery (SFA) occlusive disease is commonplace, the implications of diabetes mellitus (DM) on long-term outcomes in this population are unclear. We examined the consequences of endovascular treatment of the SFA in patients with and without DM. METHODS: A database of patients undergoing endovascular treatment of the SFA between 1986 and 2005 was maintained. Three groups were defined: nondiabetic patients, those with non-insulin-dependent DM (NIDDM), and those with insulin-dependent DM (IDDM). Intention-to-treat analysis was performed. Results were standardized to TransAtlantic Inter-Society Consensus (TASC) and Society for Vascular Surgery criteria. Time-dependent outcomes were assessed with Kaplan-Meier survival analyses. Factor analyses were performed using a Cox proportional hazard model for time-dependent variables. Data are presented as mean +/- SD where appropriate. RESULTS: Endovascular treatment (ie, balloon angioplasty +/- adjuvant stenting in 38%) was initiated in 525 limbs in 437 patients (68% male; average age, 66 +/- 14 years) for claudication failing conservative therapy or chronic critical limb ischemia (CLI). Of these, 50% were nondiabetic, 26% had NIDDM, and 24% had IDDM. Analyses were separated by those presenting with claudication (61%) and those presenting with CLI (39%). Among patients presenting with claudication, those with IDDM had significantly lower assisted primary patency (P < .01) and a higher incidence of restenosis (P = .04). Patencies at 3 years for nondiabetic, NIDDM, and IDDM were 62%, 72%, and 54% (primary), and 81%, 86%, and 65% (assisted primary), respectively. Patency and restenosis rates were associated with lesion calcification, TASC D lesion categorization, and acute periprocedural occlusion. Among patients presenting with CLI, patency and restenosis rates were equivalent across all groups; however, limb salvage was significantly worse for both groups of diabetic patients compared with nondiabetic (NIDDM, P = .01; IDDM, P = .02). Reduction in limb salvage rates was associated with presence of tissue loss at presentation, end-stage renal disease, and progression of distal disease on follow-up. CONCLUSIONS: Endoluminal therapy for SFA occlusive disease yields lower assisted patency rates and higher restenosis rates for those patients presenting with claudication who have more advanced diabetes (ie, IDDM). Among those patients presenting with CLI, particularly those with tissue loss, limb salvage rates are lowered for the diabetic groups (NIDDM and IDDM) despite equivalent patency and restenosis rates.     

Glomerular permselectivity at the onset of nephropathy in type 2 diabetes mellitus

The development of microalbuminuria in individuals with type 2 diabetes mellitus is associated with a 10-fold increase in the risk of progression to overt nephropathy and eventual end-stage renal failure. The present study reports long-term (up to 8 yr) follow-up of 43 Pima Indians with type 2 diabetes detected on screening to have microalbuminuria. The natural history of albuminuria in these individuals included progression to overt proteinuria (urinary albumin excretion > or = 300 mg/d) in half of the participants by 7 yr of follow-up. The size selectivity of the glomerular barrier was also investigated using dextran sieving and pore theory. Whereas a comparison group of macroalbuminuric Pima Indians had an excess of large pores that served as a macromolecular "shunt," individuals with microalbuminuria had a shunt size no different from long-term diabetic, normoalbuminuric control subjects. An abrupt transition from little or no relationship to a highly significant and positive relationship between increasing albuminuria and shunt size occurred at an albumin-to-creatinine ratio of approximately 3000 mg/g. Shunt size in macroalbuminuric individuals correlated with the extent of foot process broadening. Podocyte foot processes in microalbuminuric participants were not different from those in control subjects. In conclusion, although microalbuminuria in type 2 diabetic Pima Indians often heralds progressive glomerular injury, it is not the result of defects in the size permselectivity of the glomerular barrier but rather of changes in either glomerular charge selectivity or tubular handling of filtered proteins or of a combination of these two factors.     

Bone fragility in type 2 diabetes mellitus

The number of patients with osteoporosis or type 2 diabetes mellitus (T2DM) is increasing in aging and westernized societies. Both disorders predispose elderly people to disabling conditions by causing fractures and vascular complications, respectively. Recent animal studies have shown that administration of osteocalcin, which is specifically secreted from osteoblasts, can increase insulin secretion and ameliorate hyperglycemia, obesity, and high triglyceride levels in mice fed a high-fat diet. Moreover, several studies have shown that antagonism of Wnt signaling by oxidative stress contributes to the development of osteoporosis, as well as insulin resistance and hyperlipidemia. Thus, bone metabolism and glucose/fat metabolism seem to be etiologically related to each other. Meta-analyses of multiple clinical studies in humans have shown that hip fracture risk of T2DM patients is increased by 1.4-1.7-fold, although bone mineral density (BMD) is not diminished. Vertebral fracture risk of T2DM patients is also increased, and BMD is not sensitive enough to assess the risk. These findings suggest that bone fragility in T2DM, which is not reflected by BMD, depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. Pentosidine, the endogenous secretory receptor for advanced glycation endproducts, and insulin-like growth factor-I seem to be such candidates, although further studies are required to clarify whether or not these markers could predict the occurrence of new fractures of T2DM patients in a prospective fashion.     

Periodontal disease in type 2 diabetes mellitus

Objective: To determine the periodontal status in well controlled and poorly controlled type 2 diabetic patients compared with normal healthy individuals. Study Design: Cross-sectional comparative study. Place and Duration of Study: Diabetes Management Centre, Services Hospital, Lahore, from November 2009 to January 2010. Methodology: Forty well controlled and forty poorly controlled type 2 diabetic subjects having good oral hygiene (scored according to simplified oral hygiene index) were compared with a control group of forty normal healthy individuals. Probing depth (PD), gingival recession (GR), and attachment loss (AL) were recorded to obtain the periodontal status of each tooth, using a Michigan probe "0" with Williams marking. Glycemic control was evaluated by glycated Hb value. Using ANOVA and independent sample t-test, mean probing depth and attachment loss in each tooth type (incisors, canines, premolars and molars) were compared. Results: Mean age of diabetic subjects was 58.86 ± 6.21 years and that of control group was 56.92 ± 6.91 years; 60% were females. Probing depth was greater in patients with poorly controlled diabetes compared to well controlled diabetic patients and non-diabetic controls (4.21 mm vs. 3.72 mm and 2.93 mm respectively, p < 0.001). Attachment loss also increased in poorly controlled diabetes (p < 0.001) compared to the control group and well controlled diabetes, however, the difference was not statistically significant when comparing well controlled to the control group (p > 0.05). Number of sites and mean percentage of sites with attachment loss of 3 4 and 3 6 mm was also significantly higher in poorly controlled diabetes compared to the control group (p < 0.05 and p < 0.001 respectively). Conclusion: Periodontal status as estimated by probing depth and degree of attachment loss deteriorates significantly with poor glycemic control in diabetes.     

Management of type 2 diabetes mellitus in youth

The rising rates of obesity in youth have concurrently led to an increase in the rates of type 2 diabetes mellitus(T2DM) in this age group.However,there are limited data on the efficacy of different antidiabetic agents in youth.In this context,the Treatment Options for Type 2 Diabetes in Adolescents and Youth trial recently reported that the majority of obese children and adolescents 10-17-years old with newly diagnosed T2DM(T2DM duration less than 2 years) could not achieve HbA1c levels < 8% for more than 1 year with metformin monotherapy,metformin plus rosiglitazone combination,or metformin and lifestyle changes.These findings suggest that,in the majority of youth with T2DM,tight long-term glycemic control with oral agents is an elusive goal and that most patients will require treatment with insulin within a few years of diagnosis to achieve HbA1c targets and reduce the risk of macroand microvascular complications.Therefore,reducing the incidence of T2DM by preventing pediatric obesity through the implementation of lifestyle changes in the community should be the primary objective of healthcare systems.